Retinal anti-bipolar cell antibodies in a patient with paraneoplastic retinopathy and colon carcinoma.
OBJECTIVE
To describe clinical, electrophysiologic, and immunologic features of a unique paraneoplastic retinopathy with characteristics of cancer-associated and melanoma-associated retinopathy.


METHODS
Serial assessment of clinical visual function, electroretinography, and assays of anti-retinal antibodies.


RESULTS
A 51-year-old woman with progressive visual glare for 1 year had normal visual acuity and color vision, paracentral scotomas, and a normal-appearing retina. Electroretinography revealed no responses of the right eye and attenuated responses of the left eye, especially those recorded under scotopic conditions. Anti-bipolar antibodies were detected. Subsequent evaluation uncovered adenocarcinoma of the colon. Several months after resection of the tumor and chemotherapy, no evidence existed of cancer or anti-bipolar cell antibodies, and electroretinography responses were markedly improved.


CONCLUSIONS
The presence of anti-bipolar cell antibodies in a patient with retinal dysfunction is not specific of melanoma-associated retinopathy. Effective treatment of cancer may result in elimination of associated anti-retinal antibodies and improved retinal function.
Jacobson
D M
DM
Department of Neurology, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. jacobsod@mfldclin.edu
Adamus
G
G
D000230:Adenocarcinoma / Q000150:complications* / Q000601:surgery; D001323:Autoantibodies / Q000032:analysis*; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery; D004596:Electroretinography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D012160:Retina / Q000276:immunology*; D012164:Retinal Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D014794:Visual Fields
D001323:Autoantibodies