Zhou Bo, Li Guoqin, Wang Shengbo, Zhou Fang, Wu Peng
Ophthalmology Department, Zibo Zhengda Guangming Eye Hospital, Zhengda Guangming Eye Group, Zibo, China.
Radiology Department, Zibo Municipal Organs Hospital, Zibo, China.
Case Rep Ophthalmol. 2025 Apr 26;16(1):377-384. doi: 10.1159/000545942. eCollection 2025 Jan-Dec.
Melanoma-associated retinopathy (MAR) is a distinct subset within the spectrum of retinal-dysfunction disorders. It is triggered by the cross-reaction between circulating antibodies originating from malignant melanoma (MM) and retinal antigens. The timely identification of paraneoplastic retinal diseases is crucial, as it can significantly contribute to the early diagnosis and treatment of underlying malignancies. Currently, increasing awareness of the early clinical manifestations of MAR is essential for clinicians to detect primary or metastatic MMs at an earlier stage.
This report details a case of a patient who initially presented with night blindness and visual field defects as the primary symptoms. Through a comprehensive and systematic examination process, which involved detailed ophthalmological examinations and multidisciplinary diagnostic approaches, esophageal, and cardia MM was ultimately diagnosed. The patient was referred to an external hospital for comprehensive antitumor management, and posttreatment, the patient self-reported a notable improvement compared to the pretreatment state.
The purpose of sharing this case is to clarify the early clinical manifestations of MAR. It is anticipated that this will prompt clinicians to enhance their vigilance and identify primary or metastatic MMs earlier. Early treatment of the primary disease not only has the potential to reduce the risk of irreversible immune-mediated damage to retinal cells but also to improve visual outcomes. This highlights the significance of early diagnosis and intervention in the management of such diseases, providing important reference for clinicians.
黑色素瘤相关性视网膜病变（MAR）是视网膜功能障碍疾病谱中的一个独特亚型。它由源自恶性黑色素瘤（MM）的循环抗体与视网膜抗原之间的交叉反应引发。及时识别副肿瘤性视网膜疾病至关重要，因为这可显著有助于潜在恶性肿瘤的早期诊断和治疗。目前，提高对MAR早期临床表现的认识对于临床医生在更早阶段检测原发性或转移性MM至关重要。
本报告详细介绍了一例患者，该患者最初以夜盲和视野缺损为主要症状。通过全面系统的检查过程，包括详细的眼科检查和多学科诊断方法，最终诊断为食管和贲门MM。患者被转诊至外部医院进行综合抗肿瘤治疗，治疗后，患者自述与治疗前状态相比有显著改善。
分享该病例的目的是阐明MAR的早期临床表现。预计这将促使临床医生提高警惕，更早地识别原发性或转移性MM。原发性疾病的早期治疗不仅有可能降低视网膜细胞发生不可逆免疫介导损伤的风险，还能改善视力预后。这突出了早期诊断和干预在此类疾病管理中的重要性，为临床医生提供了重要参考。
