Management and Monitoring of Cancer-Associated Retinopathy

doi:10.1001/archopht.1992.01080130050025

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Vol. 110 No. 1, January 1992

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Management and Monitoring of Cancer-Associated Retinopathy

John L. Keltner, MD; Charles E. Thirkill, PhD; Nancy K. Tyler, PhD; Alan M. Roth, MD

Arch Ophthalmol. 1992;110(1):48-53.

Abstract

• Cancer-associated retinopathy is a rare paraneoplasticevent that can involve allergic reactions and result in retinaldegradation. A patient, who had a 35-year smoking history, complainedof visual loss and was found to have serum antibodies that reactedwith an extract of retina, including the previously describedretinal cancer-associated retinopathy antigen. Prednisone treatmentappeared to reduce the patient's antibody titers to normal levels.Visual fields stabilized, and the patient was able to maintainuseful vision throughout the course of treatment until his death1 year following initial diagnosis. To our knowledge, this isthe first reported case in which monitoring of antibody responsesto retinal antigens appeared to be useful in the decision whetherto initiate prednisone therapy. Rising antibody titers to thecancer-associated retinopathy antigen probably occurs beforeprogressive visual field loss and may be considered an indicationfor prompt steroid therapy.

Author Affiliations

From the Departments of Ophthalmology (Drs Keltner, Thirkill, Tyler, and Roth), Neurology and Neurological Surgery (Dr Keltner), and Pathology (Dr Roth), University of California, Davis, Medical Center.

Footnotes

Accepted for publication September 4, 1991.

Reprint requests to the Department of Ophthalmology, Universityof California, Davis, Medical Center, 1603 Alhambra Blvd, Sacramento,CA 95816 (Dr Keltner).

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