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Cancer-associated retinopathy in a patient with seminoma
Hiroki Imai1, Kouichi Ohta, Takanobu Kikuchi
1*Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Japan †Department of Ophthalmology, Matsumoto Dental University, Shiojiri, Japan ‡Department of Instrumental Analysis Research Center for Human and Environmental Science, Shinshu University, Matsumoto Japan §Department of Ophthalmology, Suzaka Hospital, Suzaka Japan ¶Department of Neurology and Rheumatology, Shinshu University School of Medicine, Matsumoto, Japan.
Purpose:
The purpose of this study was to report our findings on a patient with cancer-associated retinopathy who had seminoma.
Methods:
A 43-year-old man, who had been diagnosed with Stage 1 seminoma, complained of blurred vision. Fundus examination revealed attenuated retinal arteries, mild optic disk pallor, and a thinning of the outer nuclear layer. Ring scotomas were found in the visual fields of both eyes. The amplitudes of the electroretinograms were moderately reduced. The patient's serum was analyzed for antibodies.
Results:
Antibodies against recoverin, Hu, and Ma-2 antigens were not detected. However, Western blots of the serum detected 2 bands at 41 and 64 kDa. The 41-kDa band was an anti-retina-specific antibody. Immunoreactivity was identified in the photoreceptor layer of mice retinas. From these findings, we diagnosed the patient with cancer-associated retinopathy. The visual functions remained stable after the removal of the primary lesion at an early stage, treatment with steroids, and intravenous immunoglobulin.
Conclusion:
This is the first case of cancer-associated retinopathy because of seminoma. The progression of the disease was reduced by removing the seminoma at an early stage, treatment with steroids, and intravenous immunoglobulin.
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