Abstract
Purpose: To describe further the clinical and immunological features of cutaneous melanoma-associated retinopathy, which is an infrequent form of paraneoplastic syndrome.
Methods: We studied the salient clinical and immuno-logical aspects of a 66-year-old man with metastatic cutaneous melanoma to lymph nodes of unknown primary site who developed melanoma-associated retinopathy.
Results: There was gradual loss of vision in the left eye. Colour vision and night vision were not affected. Visual fields showed arcuate defects. A full-field electroretinogram demonstrated attenuation of the b-wave amplitude in the left eye. The a-wave was intact. Indirect immunofluorescence techniques showed that the antibody reactions took place mainly in the outer plexiform layer of the retina.
Conclusions: Bipolar cells seem to be the target in melanoma-associated retinopathy. Contrary to previous reports, night blindness may not be a universal finding.
Similar content being viewed by others
Article PDF
References
Weinstein JM, Kelman SE, Bresnick GH, Kornguth SE . Paraneoplastic retinopathy associated with anti-retinal bipolar cell antibodies in cutaneous malignant melanoma. Ophthalmology 1994;101:1236–43.
Kim RY, Retsos, S, Fitzke FW, Arden GB, Bird AC . Cutaneous melanoma associated retinopathy. Ophthalmology 1994;101:1837–43.
Kornguth SE, Kalinke, T, Grunwald GB, Schutta H, Dahl D . Antineurofilament antibodies in the sera of patients with small cell carcinoma of the lung and visual paraneoplastic syndrome. Cancer Res 1986;46:2588–95.
Grunwald GB, Kornguth SE, Towfighi J, Sassani J, Simmonds MA, Housman CM, Papadopoulos N . Autoimmune basis for visual paraneoplastic syndrome in patients with small cell lung carcinoma: retinal immune deposits and ablation of retinal ganglion cells. Cancer 1987;60:780–6.
Sawyer RA, Selhorst JB, Zimmerman LE, Hoyt WF . Blindness caused by photoreceptor degeneration as a remote effect of cancer. Am J Ophthalmol 1976;81:606–13.
Thirkill CE . Cancer associated retinopathy, the CAR syndrome. Neuro-ophthalmology 1994;14:297–323.
Thirkill CE, Tait RC, Tyler NK, Roth AM, Keltner JL . The cancer-associated retinopathy antigen is a recoverin-like protein. Invest Ophthalmol Vis Sci 1992;33:2768–72.
Gery I, Chanaud NP, Anglade E . Recoverin is highly uveitogenic in Lewis rats. Invest Ophthalmol Vis Sci 1994;35:3342–5.
Fine B, Yanoff M . Ocular histology: a text and atlas. 2nd ed. New York: Harper and Row, 1979:82–93.
Milam AH, Saari JC, Jacobson SG, Lubinski WP, et al. Autoantibodies against retinal bipolar cells in cutaneous melanoma associated retinopathy. Invest Ophthalmol Vis Sci 1993;34:91–100.
Alexander KR, Fishman GA, Peachy NS, Marchese AL, Tso MOM . ‘On’ response defect in paraneoplastic night blindness with cutaneous malignant melanoma. Invest Ophthalmol Vis Sci 1992;33:447–83.
Rush JA . Paraneoplastic retinopathy in malignant melanoma. Am J Ophthalmol 1993;115:390–1.
Berson EL, Lessel S . Paraneoplastic night blindness with malignant melanoma. Am J Ophthalmol 1988;106:307–11.
Ripps H, Carr RE, Siegel IM, Greenstein VC . Functional abnormalities in vincristine induced night blindness. Invest Ophthalmol Vis Sci 1984;25:787–94.
Gass JDM . Acute Vogt-Koyanagi-Harada like syndrome occurring in a patient with metastatic cutaneous melanoma. In: Saari KH, editor. Uveitis update: proceedings of the international symposium on uveitis. Amsterdam: Elsevier, 1984:407–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kiratli, H., Thirkill, C., Bilgiç, S. et al. Paraneoplastic retinopathy associated with metastatic cutaneous melanoma of unknown primary site. Eye 11, 889–892 (1997). https://doi.org/10.1038/eye.1997.227
Issue Date:
DOI: https://doi.org/10.1038/eye.1997.227
Keywords
This article is cited by
-
A three-year longitudinal study of retinal function and structure in patients with multiple sclerosis
Documenta Ophthalmologica (2022)
-
National Review of Melanomas in Turkey and Comparison with Clinicopathological Features of Melanomas Diagnosed at a Northwestern Academic Tertiary Center
SN Comprehensive Clinical Medicine (2021)
-
Delayed presentation of melanoma-associated retinopathy and subsequent resolution with cytoreduction surgery
Documenta Ophthalmologica (2013)
-
Presumed melanoma-associated retinopathy (MAR): a presenting sign of primary small intestinal melanoma?
International Ophthalmology (2012)
-
Autoimmune retinopathy: A review and summary
Seminars in Immunopathology (2008)