Paraneoplastic vitelliform retinopathy associated with cutaneous or uveal melanoma and metastases.
OBJECTIVE
To report unusual vitelliform fundus findings in three cases of paraneoplastic retinopathy associated with metastasised cutaneous or uveal melanoma and in one case, a unique immunoreactivity response.


METHODS
Observational case series. The histories of three patients with MAR-like paraneoplastic retinopathy were reviewed. Electroretinography, Goldmann perimetry, fluorescein angiography, and in one case optical coherence tomography, immunohistochemistry and Western blotting were performed.


RESULTS
All patients revealed similar paraneoplastic vitelliform retinal abnormalities. Symptoms in two cases differed from the classical MAR syndrome. In one case, western blotting and immunohistochemistry demonstrated antibodies against 120-kDa, a soluble photoreceptor protein. No immunoreactivity to retinal bipolar cells was detected.


CONCLUSIONS
The clinical, electrophysiological, and immunological findings in our patients suggest a melanoma associated paraneoplastic origin, like in MAR syndrome. However contrary to MAR syndrome, this paraneoplastic vitelliform retinopathy exhibits a peculiar fundus picture, consisting of serous macular detachment and nummular vitelliform lesions in the posterior pole. This could be an unusual presentation of MAR or a separate paraneoplastic entity.
Sotodeh
M
M
Rotterdam Eye Hospital, Department of Medical Retina and Uveitis, Rotterdam, Netherlands. M.Sotodeh@Lumc.nl
Paridaens
D
D
Keunen
J
J
van Schooneveld
M
M
Adamus
G
G
Baarsma
S
S
D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000556:secondary*; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000473:pathology*; D012162:Retinal Degeneration / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D014604:Uveal Neoplasms / Q000473:pathology* / Q000556:secondary*