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H Nida Nida Sen; Paraneoplastic autoimmune retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4407.
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Presentation Description :
Paraneoplastic retinopaties can be categorized into two: cancer associated retinopathy (CAR) and melanoma associated retinopathy (MAR). There are also rarer forms of paraneoplastic retinopathies. CAR most commonly occurs in small-cell carcinoma of the lung and is frequently associated with antirecoverin antibody and is believed to be the most common type of paraneoplastic retinopathy. Onset of symptoms and the detection of antiretinal autoantibodies generally precede the diagnosis of systemic cancer in CAR but may also occur concurrently. MAR describes retinopathies associated with neuroectodermal melanocyte-derived invasive tumors. It is predominantly seen in cutaneous malignant melanoma and typically diagnosed in patients with known (metastatic) melanoma. Symptoms include decrease in vision, scotomas, color vision abnormality, photopsia, or nyctalopia and findings can range from normal fundus exam to optic nerve pallor, attenuated vessels and RPE atrophy. Both rod and cone responses can be affected in CAR whereas a electronegative ERG is more typical of MAR. . Both CAR and MAR can be associated with presence of various antiretinal antibodies which are believed to play a central role in the pathogenesis. Lack of standardized clinical or laboratory criteria and presence of some of the antiretinal antibodies in healthy controls or other autoimmune disorders complicates the diagnosis and management. In the setting of a malignancy anti-inflammatory treatment choices are limited and treatment of underlying condition does not always result in improvement of retinopathy. Recent advances in the pathogenesis, diagnosis and treatment will be discussed.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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