Small cell lung cancer and progressive retinopathy

Area of Science:

• Ophthalmology
• Neurology
• Oncology

Background:

• Cancer-associated retinopathy (CAR) is a paraneoplastic neurological syndrome causing retinal degeneration, often linked to autoimmunity against retinal antigens.
• Serum autoantibodies to retinal antigens are crucial for CAR diagnosis.
• Anti-CV2/collapsin response mediator protein (CRMP)-5 antibodies are associated with neoplasms and retinopathy, sometimes with optic neuritis.

Observation:

• A 60-year-old male presented with visual disturbances and peripheral paresthesia.
• Diagnostic imaging revealed a large lung tumor, confirmed as small cell lung cancer.
• Ophthalmological evaluation identified retinopathy but not optic neuritis.

Findings:

• Serum analysis detected autoantibodies against CRMP-5 and Hu.
• This is the first reported case of CAR associated with anti-CV2/CRMP5 antibodies in the absence of optic neuritis.
• The findings suggest a specific autoimmune response in CAR.

Implications:

• This case expands the clinical spectrum of CAR and anti-CV2/CRMP5 antibody-associated paraneoplastic syndromes.
• It underscores the importance of investigating paraneoplastic retinopathy even without optic neuritis.
• Early detection and diagnosis of CAR can aid in identifying underlying neoplasms.