Abstract
Purpose::
To report a patient with cancer-associated retinopathy (CAR) who experienced multiple bouts of paraneoplastic retinopathy and optic neuropathy but responded to treatments with alemtuzumab and was able to maintain useful vision over the course of 8 years of follow-up.
Methods::
A case-report.
Results::
This patient with serologically proven CAR responded well to alemtuzumab during several bouts of paraneoplastic retinopathy and optic neuropathy over an 8-year follow-up period after the diagnosis of CAR. Because steroids, plasmapheresis, and cyclosporine were not successful, alemtuzumab was used as a new form of treatment for her paraneoplastic autoimmune retinopathy. The patient’s visual symptoms resolved and her visual acuity and visual fields improved dramatically in response to alemtuzumab, although with each attack she experienced some permanent visual-acuity and visual-field loss. The patient’s final visual outcome 8 years after the diagnosis of CAR was very good compared with previously reported outcomes in the literature, and she may be one of the longest-surviving patients with CAR ever reported.
Conclusions::
Any adult with unexplained visual loss, with rod or cone dysfunction, or with known or suspected malignancy in the absence of other neurologic symptoms should undergo a thorough investigation for CAR. The role of alemtuzumab in the treatment of paraneoplastic retinopathy and optic neuropathy should be studied in future larger-scale studies.
Keywords: CAR • drug toxicity/drug effects • optic nerve