title: Cancer-associated retinopathy presenting as retinal vasculitis with a negative ERG suggestive of on-bipolar cell pathway dysfunction.
abstract: A 62-year-old female patient presented to our clinic complaining of a 2 month history of shimmering photopsias and floaters. An ocular examination, fluorescein angiography, and electrophysiological testing were obtained that suggested either an inflammatory retinal vasculitis or a paraneoplastic syndrome. Melanoma-associated retinopathy was highly suspected despite the absence of previous history for cutaneous melanoma since an electronegative scotopic ERG was recorded on standard flash electroretinography. Additional investigations revealed the presence of a primary breast tumor with secondary lung and pancreatic metastasis that led to the diagnosis of cancer-associated retinopathy. The patient received chemotherapy and 4 months after the initial presentation her visual complaints but also her retinal function showed marked improvement. Cancer-associated retinopathy needs to be considered in patients presenting with retinal vasculitis and electrophysiological testing can tailor the approach in these cases.
authors.affiliation: Bristol Eye Hospital, Lower Maudlin Street, UK. tasosanastasakis@gmail.com
authors.forename: Anastasios
authors.initials: A
authors.lastname: Anastasakis
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Dick
authors.forename: Erika M
authors.initials: EM
authors.lastname: Damato
authors.forename: Paul G
authors.initials: PG
authors.lastname: Spry
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Majid
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy; D051245:Retinal Bipolar Cells / Q000473:pathology*; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity; D014795:Visual Pathways / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents