Nonparaneoplastic autoimmune retinopathy presenting with peripheral retinal vasoocclusion: case report

To report a case of nonparaneoplastic autoimmune retinopathy presenting with severe peripheral retinal vasoocclusion.

Interventional case report.

A 44-year-old woman complained of blurred vision and photopsia in both eyes. She has no history of cancer or autoimmune disease. Best-corrected visual acuity was 20/40 in the left eye and 20/30 in the right eye. Constriction of the visual field sparing central vision was found. Fluorescein angiography revealed severe peripheral retinal vasoocclusion, panretinal degeneration, and cystoid macular edema. Optical coherence tomography demonstrated intraretinal fluid. Electroretinography showed decreased amplitude of a- and b-waves in both scotopic and photopic tests. The implicit time was generally within normal limits. The amplitude of flicker response was also diminished. Multifocal electroretinography showed declined signal all over the macular region. Systemic workup including whole body positron emission tomography/computed tomography for cancer screening showed negative results. Only antirecoverin antibody was positive. Under the impression of nonparaneoplastic autoimmune retinopathy, systemic and local immunosuppressive therapy was given and showed improvement.

Nonparaneoplastic autoimmune retinopathies are uncommon retinal degenerations with visual loss associated with unique clinical symptoms and findings and with serum antiretinal autoantibodies. Severe peripheral retinal vasoocclusion was not reported. Early detection and timely treatment with immunosuppression could result in clinical improvement.