Cesk Slov Oftalmol. 2021 Winter;77(6):300-303. doi: 10.31348/2021/36.
Paraneoplastic optic neuropathy (PON) is a very rare condition. In this study, a case of PON whose first complaint was painless vision loss in one eye is presented. In the follow-up of our case, optic neuropathy developed in the fellow eye. Electromyography examination performed due to diffuse body pain and motor loss in the left extremity is compatible with peripheral sensorimotor polyneuropathy. Lung biopsy was planned due to EMG result and and lymphadenopathy detection in thorax computed tomography (CT). The biopsy result of the patient was reported as nonspecific hyperplasia. As the patient's complaints increased, the paraneoplastic antibody panel was requested and CV2 / CRMP5 antibody was found positive. Thereupon, as a result of repeated biopsy, our patient was diagnosed with small cell lung cancer. We think that paraneoplastic optic neuropathy should be considered in the differential diagnosis in patients with advanced age, smoking, painless subacute vision loss, optic disc swelling, and we should insist on research in this direction as in our case.
副肿瘤性视神经病变(PON)是一种非常罕见的疾病。本研究报告了一例以单眼无痛性视力丧失为首发症状的 PON 病例。在对我们的病例进行随访时,对侧眼发生了视神经病变。由于左侧肢体弥漫性躯体疼痛和运动丧失而进行的肌电图检查与周围感觉运动性多发性神经病相符。由于肌电图结果和胸部 CT 显示纵隔淋巴结肿大,计划进行肺活检。患者的活检结果报告为非特异性增生。随着患者症状的加重,请求进行副肿瘤抗体检测,发现 CV2/CRMP5 抗体阳性。随后,通过多次活检,我们的患者被诊断为小细胞肺癌。我们认为,对于年龄较大、吸烟、无痛性亚急性视力丧失、视盘肿胀的患者,应在鉴别诊断中考虑副肿瘤性视神经病变,并应像我们的病例一样坚持这方面的研究。