[Case of cancer-associated retinopathy in which immediate treatment succeeded]

Cancer-associated retinopathy (CAR) leads to progressive loss of visual functions and a small number of reports have described effective treatment for the disease. We herein report a case of a CAR patient whose visual acuity improved with corticosteroid and a radical treatment of the tumor.

A 70-year-old man with rapidly progressive loss of visual acuity and visual field was referred to our clinic. The visual acuity of the patient had decreased to finger count OD and 20/30 OS at the initial visit, though visual acuity three weeks before the initial visit was 20/16 in both eyes. The patient suffered from night blindness, Goldmann perimetry revealed ring-like scotoma, and the electroretinogram was negative. Fundus examination showed only attenuation of the vessels but no apparent sign of retinal degeneration. Chest computed tomography (CT) revealed a small cell carcinoma in the lung of 1.2 cm diameter. One week after the initial visit, as the visual acuity in both eyes decreased to hand motion, the patient was treated with chemotherapy, radiation, and corticosteroid pulse therapy. After the treatment, the visual acuity of the patient improved to 20/50 OD and 20/67 OS, but the visual field of the patient did not improve. The tumor in the lung was disappeared on CT.

Corticosteroid treatment for CAR patients may be effective when performed rapidly after clinical symptoms appear.