Andrikopoulou Angeliki, Koutsoukos Konstantinos, Chatziralli Irini, Theodossiadis Panagiotis, Tsivgoulis Georgios, Tzartos John, Anastasakis Anastasios, Zagouri Flora, Dimopoulos Meletios-Athanasios
Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Second Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Oncol Lett. 2023 Jun 1;26(1):308. doi: 10.3892/ol.2023.13894. eCollection 2023 Jul.
Cancer-associated retinopathy (CAR) is a rare paraneoplastic disorder mediated by auto-antibodies that cross-react with retinal antigens leading to gradual visual defects. Early diagnosis and initiation of treatment is crucial to avoid permanent visual loss. Although most patients with CAR respond to intravenous steroids and intravenous immunoglobulin (IVIG), there are some cases refractory to the aforementioned treatment strategies. The present study describes a case of CAR in a patient with ovarian cancer that was initially resistant to most treatment regimens (chemotherapy, steroids, IVIG). Treatment with rituximab at 375 mg/m and oral cyclophosphamide was administered and the patient showed marked improvement of visual acuity. Electroretinogram showed a 40 and 10% improvement in scotopic and photopic vision, respectively. Notably, at the most recent follow up, the patient was still in remission. In conclusion, treatment with intravenous rituximab and oral cyclophosphamide is a promising treatment option for those cases of CAR that do not respond to steroids, immunomodulatory agents and IVIG.
癌症相关性视网膜病变（CAR）是一种罕见的副肿瘤性疾病，由与视网膜抗原发生交叉反应的自身抗体介导，导致逐渐出现视觉缺陷。早期诊断和开始治疗对于避免永久性视力丧失至关重要。尽管大多数CAR患者对静脉注射类固醇和静脉注射免疫球蛋白（IVIG）有反应，但仍有一些病例对上述治疗策略无效。本研究描述了一例卵巢癌患者的CAR病例，该患者最初对大多数治疗方案（化疗、类固醇、IVIG）均耐药。给予375 mg/m的利妥昔单抗和口服环磷酰胺治疗后，患者视力有显著改善。视网膜电图显示暗视和明视视力分别提高了40%和10%。值得注意的是，在最近的随访中，患者仍处于缓解期。总之，对于那些对类固醇、免疫调节剂和IVIG无反应的CAR病例，静脉注射利妥昔单抗和口服环磷酰胺治疗是一种有前景的治疗选择。
