Severe visual loss caused by autoimmune retinopathy

Background Autoimmune retinopathy (AIR) is a rare disorder which may present as a paraneoplastic syndrome. AIR is associated with the presence of antiretinal antibodies. These antibodies are assumed to cause damage to the retina, resulting in progressive vision loss. Case description A 74yearold man visited the ophthalmologist with a serious, progressive loss of vision, without any noteworthy abnormalities at routine ophthalmological examination. The electroretinogram was characteristic of loss of photoreceptor function. Antiretinal antibodies against recoverin were detected in serum. After referral to an internist on account of a suspected diagnosis of paraneoplastic AIR, the patient was diagnosed with a lung carcinoma, confirming the diagnosis of cancerassociated paraneoplastic AIR. Conclusion An unexplained loss of vision is highly suggestive of paraneoplastic AIR, even in patients without a known malignancy. Laboratory techniques for the detection of the antiretinal antibody against recoverin have recently been implemented in the Netherlands, facilitating the diagnosis of AIR.

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