CARCINOMA-ASSOCIATED-RETINOPATHY IN THE P RESENCE OF BREAST-CARCINOMAAND A CERVICAL CARCINOID-TUMOR

Background: Carcinoma-associated retinopathy (CAR) is a rare paraneopl astic syndrome characterized by diffuse retinal photoreceptor degenera tion in the presence of an epithelial tumor. We report on three patien ts, who developed paraneoplastic retinopathy in the presence of breast carcinoma and a cervical carcinoid tumor. Materials and methods:ln ad dition to biomicroscopic, psychophysical, electrophysiological and ang iographic examinations, serum samples were obtained for immunohistoche mical staining of human retina. Results: Ring-shaped visual field defe cts with statokinetic dissociation and abnormal rod and cone responses were found. Immunohistochemical findings included reactions at the le vel of the inner segments of the photoreceptors, the outer nuclear lay er and the outer plexiform layer in absence of antirecoverin antibodie s. Conclusions: CAR should be considered in the differential diagnosis of visual loss in presence of tumors other than small-cell carcinoma of the lung. The presence of antiretinal antibodies is compatible with a tumor-induced immune response to epitopes shared by both the tumor and retinal tissue. Apparently, various retinal proteins may function as autoantigens.