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.
Subject(s)
Immunoglobulins, Intravenous/administration & dosage , Melanoma/complications , Paraneoplastic Syndromes, Nervous System/drug therapy , Paraneoplastic Syndromes, Nervous System/physiopathology , Retinal Diseases/drug therapy , Retinal Diseases/physiopathology , Autoantibodies/drug effects , Autoantibodies/immunology , Disease Progression , Electroretinography , Humans , Immunotherapy/methods , Lymph Nodes/pathology , Lymph Nodes/surgery , Male , Melanoma/immunology , Middle Aged , Neck Dissection , Neoplasm Recurrence, Local/radiotherapy , Neoplasm Recurrence, Local/surgery , Paraneoplastic Syndromes, Nervous System/immunology , Radiotherapy , Retina/drug effects , Retina/immunology , Retina/physiopathology , Retinal Bipolar Cells/drug effects , Retinal Bipolar Cells/immunology , Retinal Bipolar Cells/pathology , Retinal Diseases/immunology , Treatment Outcome , Vision, Low/drug therapy , Vision, Low/immunology , Vision, Low/physiopathology , Visual Fields/drug effects , Visual Fields/immunologyABSTRACT
PURPOSE: The evaluation of the relationships between the antibodies anti beta-2 glycoprotein I in serum and aqueous humor of the glaucoma patients to the visual field defects. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. In plasma and anterior chamber fluid the level of antibodies to beta-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. The visual field defects were examined with Humphrey static perimetry. Statistical analysis was performed using Spearman test. RESULTS: There were no significant correlations between antibodies anti beta-2 glycoprotein I, static perimetry, age and duration of the disease. CONCLUSIONS: There have not been stated any relationships between the static perimetry to antiphospholipid antibodies level in serum and aqueous humor in patients with glaucoma. It is the preliminary communication.
