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Paraneoplastic night blindness with malignant melanoma
1Berman-Gund Laboratory, Massachusetts Eye and Ear Infirmary, Boston 02114.
American Journal of Ophthalmology
|September 15, 1988
Summary
Acquired night blindness in a patient with malignant melanoma was linked to paraneoplastic effects. This condition, affecting rod signal transmission, mimicked congenital stationary night blindness.
Area of Science:
- Ophthalmology
- Oncology
- Neuroscience
Background:
- Malignant melanoma is a serious skin cancer.
- Paraneoplastic syndromes can affect various organ systems, including the eyes.
- Congenital stationary night blindness (CSNB) is a genetic disorder affecting night vision.
Observation:
- A 69-year-old hyperopic man presented with acute night blindness and visual hallucinations.
- Symptoms appeared three years post-resection of cutaneous malignant melanoma.
- Ocular examination revealed no metastatic lesions; the patient was on no medications.
Findings:
- Electroretinogram (ERG) showed abnormalities similar to those seen in CSNB with myopia.
- ERG findings were also comparable to those reported with vincristine therapy in melanoma patients.
- Metastatic melanoma was diagnosed several months after the onset of visual symptoms.
Implications:
- Acquired night blindness can be a paraneoplastic manifestation of malignant melanoma.
- The visual disturbance likely results from disrupted intraretinal rod signal transmission.
- This case highlights the importance of considering paraneoplastic effects in patients with a history of melanoma presenting with neurological or visual symptoms.