Cancer-Associated Retinopathy due to Clear Cell Renal Carcinoma

Sushant Wagley; Tu M Tran; Paul W Mallory; Michael S Lee; Karen R Armbrust; Bruce Trautman; Sandra R Montezuma

doi:10.1159/000511189

Cancer-Associated Retinopathy due to Clear Cell Renal Carcinoma

Ocul Oncol Pathol. 2021 Mar;7(1):31-35. doi: 10.1159/000511189. Epub 2020 Dec 18.

Authors

Sushant Wagley¹, Tu M Tran¹, Paul W Mallory¹, Michael S Lee¹, Karen R Armbrust², Bruce Trautman³, Sandra R Montezuma¹

Affiliations

¹ Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.
² VA Health Care System, Minneapolis, Minnesota, USA.
³ Anatomic Pathology, Fairview Southdale Hospital, Edina, Minnesota, USA.

Abstract

An 84-year-old female presented with bilateral scotomas and progressive nyctalopia over 1 year. Best-corrected visual acuity was 20/50 in both eyes with reduced color vision. Goldmann visual field showed bilateral cecocentral scotomas and generalized constriction of the visual fields. This led to an electroretinogram showing an electronegative pattern consistent with autoimmune retinopathies. Infectious workup was negative. Anti-retinal antibodies were positive, leading to a presumed diagnosis of cancer-associated retinopathy (CAR). Imaging showed a previously unknown left renal lower pole mass, and she underwent a radical nephrectomy. Biopsy showed nuclear grade-3 clear cell renal carcinoma staged T1. The patient was treated with oral prednisone with no ocular improvement. We report on a rare case of clear cell renal carcinoma causing CAR. CAR is an important paraneoplastic syndrome to diagnose since the majority of ocular cases precede other manifestations of malignancy. Therefore, a timely diagnosis of CAR can be lifesaving or at least life-extending.

Keywords: Autoimmune retinopathy; Cancer-associated retinopathy; Goldmann visual field; Paraneoplastic syndrome; Renal carcinoma.

Publication types

Case Reports