title: [Melanoma-associated retinopathy with night blindness. Case report].
abstract: BACKGROUND
  Night blindness is usually symptomatic of retinal dysfunction. However, apart from congenital forms of night blindness such as congenital stationary night blindness (CSNB) and pigmentary retinopathy without clumping of pigment, the acquired forms of night blindness present a particular diagnostic challenge to the ophthalmologist.
  
  
  METHODS
  A 51-year-old patient with formerly healthy eyes presented with malignant skin melanoma and sudden night blindness. Along with reduced acuity, concentric visual field limitation, and a marked decrease in sensitivity of the retinal rods and cones in adaptometrical tests, significantly reduced b waves and intact a waves were registered in the flash-ERG of both eyes with otherwise inconspicuous morphologic findings. Furthermore, serum levels of antibodies (IgG) against retinal bipolar cells were found to be increased.
  
  
  CONCLUSIONS
  Results indicate the presence of melanoma-associated retinopathy (MAR), which-like carcinoma-associated retinopathy (CAR)-ranks among the tumor-associated diseases of the retina. CAR, MAR, and CSNB can be differentiated immunohistochemically by serum autoantibody determination and electrophysiologically by flash-ERG. As opposed to CAR, the immune response in the case of MAR is not to antigens of photoreceptors and ganglion cells, but to retinal so-called ON-depolarizing bipolar cells mainly connected in series to the rods. In addition, a waves are intact and b waves extinct, resembling the situation of CSNB.
authors.affiliation: Augenklinik und Poliklinik rechts der Isar, Technische Universität München.
authors.forename: M
authors.initials: M
authors.lastname: Klopfer
authors.forename: T
authors.initials: T
authors.lastname: Schmidt
authors.forename: K P
authors.initials: KP
authors.lastname: Leipert
authors.forename: I
authors.initials: I
authors.lastname: Ugi
authors.forename: K
authors.initials: K
authors.lastname: Boeck
authors.forename: S
authors.initials: S
authors.lastname: Hofmann
mesh_terms: D001323:Autoantibodies / Q000097:blood; D005260:Female; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000276:immunology; D008875:Middle Aged; D009755:Night Blindness / Q000175:diagnosis* / Q000276:immunology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000276:immunology; D012160:Retina / Q000276:immunology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000276:immunology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D001323:Autoantibodies