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S. Michels, D. Barthelmes, C. Amstutz, M. Kurz-Levin; Normalization of Functional and Anatomic Changes in Carcinoma Associated Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):338.
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Multi-modality follow-up in a case of Carcinoma Associated Retinopathy (CAR) in non-small-cell lung carcinoma.
High resolution optical coherence tomography (OCT), fluorescein angiography (FA) and electroretinogram (ERG) were used in addition to routine ophthalmic exam to document functional and anatomic changes in CAR under systemic steroid therapy.
A patient with progressive deterioration in visual acuity (VA) to less than 20/100 OU presented with granular, macular changes of the retinal pigment epithelium (RPE) and attenuated retinal vasculature. Baseline evaluation revealed by OCT an extended destruction and clumping of the photoreceptor layer, focal, perifoveal staining and leakage by FA and significant impairment of cone and rod function by ERG. The diagnosis of CAR in case of a newly detected non-small-cell lung carcinoma was made. Parallel to systemic steroid therapy a continuous improvement in retinal structure (OCT), a regression of staining and leakage (FA), and an improvement in photoreceptor function (ERG) was detectable. Visual acuity improved to better than 20/32 in both eyes and RPE changes regressed.
Despite destruction of the photoreceptor band in OCT and the photoreceptor function in ERG significant functional and anatomic improvement is possible in CAR.
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