Improvement in visual fields in a patient with melanoma-associated retinopathy treated with intravenous immunoglobulin

Chereddy Subhadra; Arkadiusz Z Dudek; Pamela P Rath; Michael S Lee

doi:10.1097/WNO.0b013e31816754c4

Improvement in visual fields in a patient with melanoma-associated retinopathy treated with intravenous immunoglobulin

J Neuroophthalmol. 2008 Mar;28(1):23-6. doi: 10.1097/WNO.0b013e31816754c4.

Authors

Chereddy Subhadra¹, Arkadiusz Z Dudek, Pamela P Rath, Michael S Lee

Affiliation

¹ Division of Hematology, Oncology, and Transplantation (CS, AZD), University of Minnesota, Minneapolis, Minnesota 55455, USA.

PMID: 18347454
DOI: 10.1097/WNO.0b013e31816754c4

Abstract

Melanoma-associated retinopathy (MAR) is a rare disorder characterized by photopsias, shimmering vision, nyctalopia, and dysfunction of rod photoreceptor cells. We describe a 56-year-old man with metastatic cutaneous melanoma to the lymph nodes and MAR. He underwent resection of the metastasis followed by radiation therapy. Over the ensuing 2 months, visual function worsened so he was treated with intravenous immunoglobulin (IVIg). Visual fields, but not electroretinography, improved steadily over the next year. No evidence of recurrence or metastatic disease has been found. Our patient indicates that even after a reduction or elimination of melanoma tumor burden and presumably the attenuation of the antigenic stimulus driving MAR, this disorder can continue to progress. In this setting, IVIg therapy should be considered a viable treatment option.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Autoantibodies / drug effects
Autoantibodies / immunology
Disease Progression
Electroretinography
Humans
Immunoglobulins, Intravenous / administration & dosage*
Immunotherapy / methods
Lymph Nodes / pathology
Lymph Nodes / surgery
Male
Melanoma / complications*
Melanoma / immunology
Middle Aged
Neck Dissection
Neoplasm Recurrence, Local / radiotherapy
Neoplasm Recurrence, Local / surgery
Paraneoplastic Syndromes, Nervous System / drug therapy*
Paraneoplastic Syndromes, Nervous System / immunology
Paraneoplastic Syndromes, Nervous System / physiopathology*
Radiotherapy
Retina / drug effects
Retina / immunology
Retina / physiopathology
Retinal Bipolar Cells / drug effects
Retinal Bipolar Cells / immunology
Retinal Bipolar Cells / pathology
Retinal Diseases / drug therapy*
Retinal Diseases / immunology
Retinal Diseases / physiopathology*
Treatment Outcome
Vision, Low / drug therapy
Vision, Low / immunology
Vision, Low / physiopathology
Visual Fields / drug effects
Visual Fields / immunology

Substances

Autoantibodies
Immunoglobulins, Intravenous