title: Unilateral cancer-associated retinopathy: a case report.
abstract: We write to report a rare case of unilateral cancer-associated retinopathy previously undocumented in the literature. Cancer-associated retinopathy is an uncommon paraneoplastic syndrome. It is characterised by retinal antigen autoantibodies causing rod and cone dysfunction and abnormal electroretinography findings with consequent progressive visual loss.Our patient, known to have a primary cervical intraepithelial neoplasia, presented with unilateral blurred vision as well as a disturbance in colour and night vision. Electroretinography findings of reduced a and b waves in the right eye, together with a fundoscopic appearance of a mottled retinal pigment epithelium, attenuated blood vessels and optic disc pallor were consistent with unilateral cancer-associated retinopathy. Posterior subtenon injections of triamcinolone were administered to control active disease. With periocular steroid injections, at 4 years, our patient's visual acuity remained relatively stable and her condition persisted strictly unilaterally. Cancer-associated retinopathy may be the first presenting sign of an underlying malignancy or may indicate its recurrence. Moreover, in patients with a diagnosed gynaecological malignancy, visual symptoms could reflect cancer-associated retinopathy. In our patient visual symptoms came secondary to the diagnosis of cancer.
authors.affiliation: 4th Year Medical Student, Cardiff University, UK.
authors.forename: Zartash
authors.initials: Z
authors.lastname: Javaid
authors.affiliation: 4th Year Medical Student, Cardiff University, UK.
authors.forename: Shahzaib M
authors.initials: SM
authors.lastname: Rehan
authors.affiliation: Consultant Medical Ophthalmologist and Honorary Lecturer, Cardiff Eye Unit, University hospital of Wales, UK ayadberman@hotmail.com.
authors.forename: Ayad
authors.initials: A
authors.lastname: Al-Bermani
authors.affiliation: Consultant, Medical Physics Department, University Hospital of Wales, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Payne
mesh_terms: D000328:Adult; D001324:Autoantigens / Q000276:immunology; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D009364:Neoplasm Recurrence, Local; D059545:Paraneoplastic Syndromes, Ocular / Q000209:etiology / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology*; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000473:pathology*
chemical_list: D001324:Autoantigens; D013256:Steroids
keywords: CAR; Cancer-associated retinopathy; autoimmune; retina; unilateral