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Cancer-associated retinopathy secondary to gallbladder carcinoma
Karel Goyvaerts1, Tanja Coeckelbergh1, Pieter-Paul Schauwvlieghe2
1Antwerp University Hospital, Department of Ophthalmology, Edegem, Belgium.
GMS Ophthalmology Cases
|October 10, 2024
Summary
Cancer-associated retinopathy (CAR) can be a rare complication of gallbladder carcinoma. Early diagnosis and combined treatment with corticosteroids and chemotherapy improved vision in a patient with this rare condition.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Cancer-associated retinopathy (CAR) is an autoimmune disorder characterized by vision loss due to antibodies targeting retinal cells.
- Gallbladder carcinoma is an uncommon malignancy, and its association with CAR is exceedingly rare.
Observation:
- A 57-year-old man presented with rapidly progressive bilateral vision loss.
- Ophthalmic examination revealed vitritis, electronegative full-field electroretinography (FF-ERG), ocular coherence tomography (OCT) abnormalities, and fundus autofluorescence (FAF) lesions.
- Positron emission tomography-computed tomography (PET-CT) identified metastasized gallbladder carcinoma.
Findings:
- The patient was diagnosed with cancer-associated retinopathy secondary to gallbladder carcinoma.
- Fluorescence in situ hybridization (FISH) confirmed seropositivity for anti-retinal autoantibodies.
- Treatment with high-dose corticosteroids and a carboplatin-etoposide chemotherapy regimen led to significant visual improvement.
Implications:
- This case highlights the importance of considering CAR in patients with unexplained vision loss, particularly those with uveitis and retinal abnormalities.
- A comprehensive diagnostic work-up, including FF-ERG, OCT, FAF, and PET-CT, is crucial for diagnosing CAR and identifying the underlying malignancy.
- While combined immunosuppressive and anti-tumoral therapy can improve vision, long-term visual prognosis in CAR remains guarded.
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