Cancer associated retinopathy
Paraneoplastic autoimmune retinopathy linked to cancer and vision loss.
Cancer associated retinopathy (CAR) is an immune-mediated paraneoplastic disease that affects the retina and can lead to blindness. It is associated with various types of cancer and is treated with a combination of chemotherapy and immunosuppression.
Quick Facts
- Field
- Ophthalmology, optometry
- Complications
- Blindness
- Diagnosis
- Eye examination
- Differential
- Retinitis pigmentosa
- Treatment
- Immunosuppression
Facts from the source article.
Did You Know?
- Patients may experience night blindness, prolonged glare after light exposure, and defects in color vision (dyschromatopsia).
- Major signs include circulating anti-retinal antibodies and loss of the outer retinal layer including the ellipsoid layer and photoreceptor cells.
- Diagnosis is challenging because signs and symptoms overlap with many other retinal diseases.
Pathophysiology
CAR arises from the interaction between retinal antigen expression in cancer tissues and the host's systemic immune response. This triggers an autoimmune response that produces antibodies cross-reacting with retinal antigens, leading to retinal degeneration and apoptosis. Recoverin is the most common antigen involved.
Treatment
Long-term systemic immunosuppressive therapy is the main treatment for CAR, often combined with chemotherapy. Medications include corticosteroids, cyclosporin, azathioprine, and alemtuzumab. Intravenous immunoglobulin can neutralize autoantibodies, and various monoclonal antibodies are also used. Tumor removal does not influence CAR progression.
More in Steroid-responsive Inflammatory Conditions
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced