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Khalid F Tabbara, Mahmoud O Jaroudi, Samir S Shoughy, Haytham I Salti; Cancer-Associated Retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):90.
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To study the visual outcome and risk factors of cancer-associated retinopathy.
Three patients with sudden visual loss and normal eye exam were assessed. Each patient underwent complete eye exam including visual acuity, fundus exam, color vision, and visual fields at presentation and after therapy. Blood was obtained for anti-retinal antibodies, anti-enolase S antibodies, optic nerve auto-antibodies and recoverin antibodies. ERG, EOG, VEP, and brain MRI were also requested and helped in establishing the diagnosis. Patients were treated with steroids, mycophenolate mofetil, or both.
There were 1 male and 2 female patients. Ages of the patients were 46, 59 and 33 years (mean age, 46 years). All 3 patients had positive anti-retinal antibodies. ERG and visual fields were abnormal. One patient had endometrial carcinoma and work-up following her ocular symptoms revealed distant metastases. The second patient had small cell carcinoma of the breast and underwent mastectomy and chemotherapy. The third patient had cancer associated retinopathy as the first manifestation of pinealoma which was discovered on MRI. The final visual outcome after therapy was variable. The patient with pinealoma associated retinopathy regained 20/20 vision after therapy.
Cancer-associated retinopathy is a rare autoimmune ocular disease that can be easily overlooked especially when the clinical eye exam is normal. It may be the main presenting manifestation of a serious systemic malignancy. Detailed history and targeted work-up including specific anti-retinal antibodies are crucial for diagnosis.
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