Clinical and immunocytochemical findings in a case of melanoma-associated retinopathy.
OBJECTIVE
To describe an unusual case of melanoma-associated retinopathy (MAR).


METHODS
Retrospective, observational case report and experimental study.


METHODS
A 61-year-old man with a history of cutaneous melanoma, acquired bilateral central scotomas, and night blindness.


METHODS
Serial full-field electroretinography (ERG) and Goldmann perimetry were performed. Serum was screened for cancer-associated retinopathy (CAR) antibodies by Western blotting. Sections of human and rat retina were examined by immunofluorescence microscopy to determine whether retinal cells were reactive with this patient's serum. A metastatic workup was performed.


METHODS
Electroretinography, Goldmann visual field testing, and immunocytochemistry were performed.


RESULTS
The results were as follows: (1) The ERG showed a profound loss of the b-wave amplitude and a "negative" b-wave characteristic of congenital stationary night blindness; (2) a central scotoma and peripheral constriction were identified on Goldmann visual field tests; (3) as in other patients with MAR, bipolar cells in human and rat retinas were immunolabeled with this patient's serum; and (4) a previously unsuspected focus of metastatic melanoma was discovered.


CONCLUSIONS
Recognition of this condition may help to identify an occult focus of metastatic melanoma.
Potter
M J
MJ
Department of Ophthalmology, University of British Columbia, Vancouver, Canada. mpotter@interchange.ubc.ca
Thirkill
C E
CE
Dam
O M
OM
Lee
A S
AS
Milam
A H
AH
D015153:Blotting, Western; D002135:Calcium-Binding Proteins / Q000032:analysis; D004596:Electroretinography; D005136:Eye Proteins; D051597:Hippocalcin; D006801:Humans; D007150:Immunohistochemistry; D008074:Lipoproteins; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000503:physiopathology / Q000556:secondary*; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D009755:Night Blindness / Q000473:pathology*; D010257:Paraneoplastic Syndromes / Q000473:pathology* / Q000503:physiopathology; D051603:Recoverin; D012160:Retina / Q000503:physiopathology; D019572:Retinal Neoplasms / Q000737:chemistry / Q000503:physiopathology / Q000556:secondary*; D012189:Retrospective Studies; D012607:Scotoma / Q000473:pathology*; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields
D002135:Calcium-Binding Proteins; D005136:Eye Proteins; D008074:Lipoproteins; D009419:Nerve Tissue Proteins; C496731:RCVRN protein, human; D051603:Recoverin; D051597:Hippocalcin