Clinical and immunocytochemical findings in a case of melanoma-associated retinopathy

Ophthalmology. 1999 Nov;106(11):2121-5. doi: 10.1016/S0161-6420(99)90493-1.


Objective: To describe an unusual case of melanoma-associated retinopathy (MAR).

Design: Retrospective, observational case report and experimental study.

Participants: A 61-year-old man with a history of cutaneous melanoma, acquired bilateral central scotomas, and night blindness.

Intervention: Serial full-field electroretinography (ERG) and Goldmann perimetry were performed. Serum was screened for cancer-associated retinopathy (CAR) antibodies by Western blotting. Sections of human and rat retina were examined by immunofluorescence microscopy to determine whether retinal cells were reactive with this patient's serum. A metastatic workup was performed.

Main outcome measures: Electroretinography, Goldmann visual field testing, and immunocytochemistry were performed.

Results: The results were as follows: (1) The ERG showed a profound loss of the b-wave amplitude and a "negative" b-wave characteristic of congenital stationary night blindness; (2) a central scotoma and peripheral constriction were identified on Goldmann visual field tests; (3) as in other patients with MAR, bipolar cells in human and rat retinas were immunolabeled with this patient's serum; and (4) a previously unsuspected focus of metastatic melanoma was discovered.

Conclusions: Recognition of this condition may help to identify an occult focus of metastatic melanoma.

Publication types

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

MeSH terms

  • Blotting, Western
  • Calcium-Binding Proteins / analysis
  • Electroretinography
  • Eye Proteins*
  • Hippocalcin
  • Humans
  • Immunohistochemistry
  • Lipoproteins*
  • Male
  • Melanoma / chemistry
  • Melanoma / physiopathology
  • Melanoma / secondary*
  • Microscopy, Fluorescence
  • Middle Aged
  • Nerve Tissue Proteins*
  • Night Blindness / pathology*
  • Paraneoplastic Syndromes / pathology*
  • Paraneoplastic Syndromes / physiopathology
  • Recoverin
  • Retina / physiopathology
  • Retinal Neoplasms / chemistry
  • Retinal Neoplasms / physiopathology
  • Retinal Neoplasms / secondary*
  • Retrospective Studies
  • Scotoma / pathology*
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / physiopathology
  • Visual Field Tests
  • Visual Fields


  • Calcium-Binding Proteins
  • Eye Proteins
  • Lipoproteins
  • Nerve Tissue Proteins
  • RCVRN protein, human
  • Recoverin
  • Hippocalcin