Paraneoplastic Syndromes in Neuro-Ophthalmology

Paraneoplastic syndromes that affect the visual pathways and present with neuro-ophthalmologic signs or symptoms may involve the afferent or efferent systems. Afferent syndromes may involve the optic nerve or retina and, in some cases, these may be associated with systemic neurologic disease. Efferent symptoms typically affect eye movements and may involve the neuromuscular junction or involuntary eye movements.

Literature review and personal clinical and research experience.

Diagnosis of paraneoplastic syndromes relies on clinical and laboratory evaluations. In the appropriate clinical setting, the presence of specific antibodies may help confirm the diagnosis.

In some cases, the visual pathway disturbance precedes a diagnosis of malignancy. Astute observation and selective evaluation and management are critical to establish the correct diagnosis and institute therapeutic approaches that can be sight or life saving.