Atlas of Ophthalmology

Cancer-associated Retinopathy in Breast Carcinoma CAR (Colour Image, OCT, Perimetry, ERG, VEP)

Retina -> Aquired Macular Diseases
A 39-year-old woman presented with a history of bilateral vision loss. She had VA of 0.2/0.4. Fundus examination showed no signs of inflammation, no narrowing of the retinal arterioles and no diabetic retinopathy. Systemic examination revealed malignant mamma carcinoma. 1) The optic nerve head (L>R) showing a temporal paleness. 2) Optical coherence tomography presenting a thinning of the outer retinal layer. 3) w-w-perimetry showing a central scotoma R/L. 4) The amplitudes of the electroretinogram and the visual evoked response were strongly decreased, the latencies were normal. Based on these observations, the patient was diagnosed as having CAR. Anti-recoverin antibody was not tested in the patient's serum. She was treated with steroid therapy, but her visual acuity did not improve. Cancer-associated retinopathy (CAR) is a paraneoplastic neurological syndrome resulting in progressive loss of vision and clinical signs of retinal degeneration. It is associated with various types of cancer and is also considered to be an autoimmune disorder that involves cross-reaction between autoantibodies and retinal proteins.

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