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Cancer-Associated Retinopathy

CAR Syndrome


Presentation

  • The patient died of pneumonia 2 years after presentation.[ncbi.nlm.nih.gov]
  • A 62-year-old female patient presented to our clinic complaining of a 2 month history of shimmering photopsias and floaters.[ncbi.nlm.nih.gov]
  • This is the first reported case of SCLC-associated CAR to present with chorioretinitis.[ncbi.nlm.nih.gov]
  • CAR can present with periphlebitis and a negative-type ERG. Greater awareness of these associations may allow for earlier detection of future cases.[ncbi.nlm.nih.gov]
  • A 67-year-old woman with small-cell endometrial carcinoma suffering from deterioration of visual acuity is presented.[ncbi.nlm.nih.gov]
Short Arm
  • Using a 7 kb subclone of the human recoverin gene, a positive fluorescence in situ hybridization signal was demonstrated near the terminus of the short arm of chromosome 17 at position p13.1.[ncbi.nlm.nih.gov]
Suggestibility
  • Invasive thymoma was considered to be the causative tumor because there had been no evidence that suggested other systemic malignancy during more than 3 years of follow-up.[ncbi.nlm.nih.gov]
  • Taken together, our present data suggest that peripheral activation of recoverin-specific antitumor CTL is likely to contribute to the preferable prognosis of CAR( ) cancer patients.[ncbi.nlm.nih.gov]
  • This strongly suggested that the 23-kDa antigen and recoverin are identical proteins.[ncbi.nlm.nih.gov]
  • Regarding antibody generation in CAR, a high incidence of aberrant expression of recoverin in cancer tissues is important, as suggested previously.[ncbi.nlm.nih.gov]
  • This suggests that anti-enolase antibodies could be responsible for the development of CAR symptoms.[ncbi.nlm.nih.gov]

Workup

Retinal Phlebitis
  • Cancer-associated retinopathy with retinal phlebitis. Y Ohnishi , S Ohara , T Sakamoto , T Kohno and F Nakao Department of Ophthalmology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.[bjo.bmj.com]
  • phlebitis, Br J Ophthalmol, 1993 , vol. 77 (pg. 795 - 8 ) 11 Selective immunohistochemical staining in the paraneoplastic retinopathy syndrome, Ophthalmology, 1992 , vol. 99 (pg. 1286 - 95 ) 12 Treatment of paraneoplastic visual loss with intravenous[academic.oup.com]
HLA-B27
  • One patient had a previous diagnosis of systemic lupus erythematosus (patient 3), two patients had a previous diagnosis of birdshot retinochoroidopathy (patients 5 and 6), and one patient had a previous diagnosis of HLA-B27-positive panuveitis and vasculitis[dovepress.com]

Treatment

  • During treatment, there was progressive improvement in symptoms and the ERG normalized. Serology confirmed complete clearance of autoantibodies.[ncbi.nlm.nih.gov]
  • When cancer-associated retinopathy is suspected, a comparatively large quantity of steroids and anticancer treatment should be combined immediately.[ncbi.nlm.nih.gov]
  • Subsequent chest X-ray and CT scan showed partial regression of both primary tumor and lymph node metastasis without anticancer treatment.[ncbi.nlm.nih.gov]
  • Further understanding of CAR pathogenesis may offer potential avenues for treatment.[ncbi.nlm.nih.gov]
  • Prednisone treatment appeared to reduce the patient's antibody titers to normal levels.[ncbi.nlm.nih.gov]

Prognosis

  • Taken together, our present data suggest that peripheral activation of recoverin-specific antitumor CTL is likely to contribute to the preferable prognosis of CAR( ) cancer patients.[ncbi.nlm.nih.gov]
  • Various immunomodulatory therapies have also been described with varying responses, but the overall visual prognosis remains poor.[ncbi.nlm.nih.gov]
  • Despite potential options for treatment, none have demonstrated much efficacy, and the visual prognosis is typically poor.[ncbi.nlm.nih.gov]
  • Prognosis The ophthalmological prognosis varies depending on the clinical course of CAR, ranging from progressive visual loss to blindness. The overall prognosis varies depending on the type of cancer present.[orpha.net]

Etiology

  • CONCLUSIONS AND CLINICAL RELEVANCE: The etiology of SARDS in dogs does not appear to be similar to cancer-associated retinopathy in humans on the basis of absence of differential antibody activity against retinal proteins.[ncbi.nlm.nih.gov]
  • Etiology The exact etiology remains unknown but an autoimmune mechanism may contribute to the development of retinal degeneration. No known genetic association has been reported.[orpha.net]
  • 274 1541 Myohistological Investigations 275 155 Treatment 276 1552 Symptomatic Treatment 277 156 Differential Diagnosis 278 1563 Congenital Fibrosis of the Extraocular Muscles 279 Treatment of Specific Types of Nystagmus 283 161 Introduction 284 16211 Etiology[books.google.com]
  • Etiology There has been different antibodies isolated against many specific retinal proteins: Recoverin Carbonic anhydrase II Transducin B [Alpha]-enolase TULP1 [Tubby-like Protein 1] PNR photoreceptor cell-specific nuclear receptor Heat shock cognate[eyewiki.aao.org]

Epidemiology

  • Summary Epidemiology The prevalence is unknown but around 100 cases have been reported in the literature.[orpha.net]
  • Plasma exchange Ataxia with antibodies to CARP 8 10 Epidemiology: 1 patient; 77 year old female Clinical: Pure cerebellar syndrome Onset: 3 years after neoplasm Ataxia: Limb; Truncal; Gait; Dysarthria Ocular: Horizontal nystagmus Mental status: Normal[neuromuscular.wustl.edu]
  • Diagnosis : Interferon-associated Retinopathy Epidemiology: No age/gender predilection Pre-existing arteriosclerosis that affects microcirculation may promote development of retinopathy Signs: Cotton wool spots especially around the optic nerve Retinal[webeye.ophth.uiowa.edu]
Sex distribution
Age distribution

Pathophysiology

  • We discuss the typical clinical symptoms as well as the pathophysiology of this uncommon disorder.[ncbi.nlm.nih.gov]
  • Offers the most comprehensive content available on retina, balancing the latest scientific research and clinical correlations, covering everything you need to know on retinal diagnosis, treatment, development, structure, function, and pathophysiology.[books.google.com]
  • Comprehensively updated to reflect everything you need to know regarding retinal diagnosis, treatment, development, structure, function, and pathophysiology, this monumental ophthalmology reference work equips you with expert answers to virtually any[books.google.com]
  • Pathophysiology Keltner et al developed an autoimmune theory in 1983 when he found antibodies against retinal photoreceptors in patient with lymphoma who developed acute vision loss and retinal degeneration.[eyewiki.aao.org]
  • […] affected patients' serum with the inner segments and nuclei of rods and cones and the outer plexiform layer of the retina, in MAR, affected patients' serum reacts with the bipolar cell layer of the retina.2 Two mechanisms have been postulated as the pathophysiologic[ispub.com]

Prevention

  • Corticosteroid therapy could not prevent deterioration of visual acuity and field.[ncbi.nlm.nih.gov]
  • Corticosteroid therapy failed to prevent visual loss. She was found to possess antibodies against retinal 45 kd protein. This led to a diagnosis of cancer-associated retinopathy with atypical protein profile.[ncbi.nlm.nih.gov]
  • Funding and Disclosures Supported by grants from Research to Prevent Blindness, Fight for Sight, the National Society for the Prevention of Blindness, and Retinitis Pigmentosa International.[nejm.org]
  • The study was fund in part by the grant from National Eye Institute EY13053 (GA), EY10572 (DC), and unrestricted grant to Casey Eye Institute from the Foundation to Prevent Blindness.[omicsonline.org]
  • ., Interdisciplinary Center of Ophthalmic Preventive Medicine and Imaging, Department of Ophthalmology, Friedrich-Alexander-University, Erlangen, Deutschland ICD10-Code: H35.0, D05.7 Path: Retina - Aquired Macular Diseases - Cancer-associated Retinopathy[atlas-1-elastic.atlasoph.com]

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