title: Carcinoma-associated retinopathy in a young teenager with immature teratoma of the ovary.
abstract: A 14-year-old African American girl presented with diminished vision in both eyes 1 week after undergoing an oophorectomy for a right ovarian mass. Systemic metastatic work-up was negative. Visual acuity was 20/40 in the right eye and 20/50 in the left eye. Slit-lamp biomicroscopy was unremarkable in both eyes. Fundus examination showed diffuse patchy areas of retinal pigment epithelial atrophy in the macula and peripheral retina bilaterally. Color vision had decreased in each eye. Electroretinography revealed nondetectable rod and cone responses. Both pattern and flash visual evoked potential (VEP) testing showed delayed latency in both eyes. She was treated with pulse intravenous methylprednisolone for 3 days along with intravenous immunoglobulins and rituximab, followed by systemic prednisolone and biweekly intravenous immunoglobulins and rituximab for 3 months. Antiretinal autoantibodies against 48-kDa (arrestin) and 64-kDa and 94-kDa proteins were positive, suggestive of carcinoma-associated retinopathy. After 3 months, visual acuity was 20/40 in each eye with improvement in color vision and VEP findings.
authors.affiliation: Ophthalmology Department, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Kiran
authors.initials: K
authors.lastname: Turaka
authors.affiliation: Division of Pediatric Rheumatology, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kietz
authors.affiliation: Hematology and Oncology Department, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Lakshmanan
authors.initials: L
authors.lastname: Krishnamurti
authors.affiliation: Ophthalmology Department, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Ellen
authors.initials: E
authors.lastname: Mitchell
authors.affiliation: Ophthalmology Department, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Hannah
authors.initials: H
authors.lastname: Scanga
authors.affiliation: Ophthalmology Department, Children's Hospital of Pittsburgh, University of Pittsburgh.
authors.forename: Valeria L N
authors.initials: VL
authors.lastname: Fu
authors.affiliation: Ophthalmology Department, Children's Hospital of Pittsburgh, University of Pittsburgh. Electronic address: sylvestercl@upmc.edu.
authors.forename: Christin
authors.initials: C
authors.lastname: Sylvester
mesh_terms: D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019393:Arrestin / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D003117:Color Vision Defects; D004359:Drug Therapy, Combination; D004596:Electroretinography; D005074:Evoked Potentials, Visual; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D059545:Paraneoplastic Syndromes, Ocular / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D000069283:Rituximab; D013724:Teratoma / Q000473:pathology* / Q000601:surgery; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D019393:Arrestin; D001323:Autoantibodies; D001324:Autoantigens; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D000069283:Rituximab; D011239:Prednisolone; D008775:Methylprednisolone