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Cancer-Associated Retinopathy and Optic Neuropathy in a Patient with Lung Adenocarcinoma
Kaela Braue1, Luke K Chehade1,2,3, Rogan Fraser1
1The Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
Introduction:
Paraneoplastic vision loss includes a heterogenous group of ocular disorders that occur in the setting of systemic malignancy. The presenting symptoms are variable but typically include vision loss that is painless, subacute in onset, and ultimately bilateral. The underlying mechanism is thought to involve molecular mimicry due to structural homology between ocular and cancer antigens. Very few cases have reported simultaneous retinopathy and optic neuropathy.
Case Presentation:
Here, we present the case of a 36-year-old female who developed complete vision loss in the right eye, with both retina and optic nerve changes. Extensive investigation revealed a non-mucinous lung adenocarcinoma.
Conclusion:
Presentations of paraneoplastic vision loss include cancer-associated retinopathy, paraneoplastic optic neuropathy, paraneoplastic vitelliform maculopathy, bilateral diffuse uveal melanocytic proliferation, melanoma-associated retinopathy, and opsoclonus-myoclonus syndrome. We suggest use of the term CARON (cancer-associated retinopathy and optic neuropathy) for cases such as this.
Insights
Paraneoplastic vision loss, a rare cancer complication, can affect both the retina and optic nerve. We propose the term CARON (cancer-associated retinopathy and optic neuropathy) for simultaneous cases.
Area of Science:
- Ophthalmology
- Oncology
- Neuro-oncology
Background:
- Paraneoplastic vision loss encompasses diverse ocular disorders linked to systemic cancer.
- Symptoms often include painless, subacute, bilateral vision loss.
- The presumed mechanism is molecular mimicry between ocular and tumor antigens.
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