Improvement of reduced electroretinographic responses in thymoma-associated retinopathy: a case report and literature re
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CLINICAL CASE REPORT
Improvement of reduced electroretinographic responses in thymoma-associated retinopathy: a case report and literature review Kei Mizobuchi . Takaaki Hayashi . Satoshi Katagiri . Euido Kim . Yasutsugu Ishiba . Sumiko Watanabe . Takahisa Furukawa . Tadashi Nakano
Received: 10 January 2020 / Accepted: 17 March 2020 Ó Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To report a patient with thymoma-associated retinopathy presenting as having a good visual prognosis. Methods Case report and literature review. Case report A 42-year-old female patient was referred to our hospital for complaints of sudden visual-field defects bilaterally. Decimal corrected visual acuity (VA) was 1.5 and 1.2 in the right (RE) and left eyes (LE), respectively. Fundus autofluorescence revealed hyper-autofluorescence from the posterior pole to mid-peripheral retina in both eyes. Fullfield electroretinography (ERG) amplitudes were reduced to 20–50% and 30–50% of our controls for the scotopic and photopic conditions, respectively. A systemic examination revealed the presence of thymoma, and the patient underwent thymectomy and
immunosuppression therapies. Immunohistochemical analysis using the patient’s serum showed immunolabeling on the photoreceptor inner segment and outer plexiform layer in the monkey retina. Two years later, VA remained at 1.5 and 1.2 in RE and LE. ERG amplitudes improved to 30–60% of the controls for the scotopic conditions. However, photopic ERG showed no remarkable change. Conclusions To our knowledge, improvement of reduced rod-mediated ERG responses has not been described in seven previously reported patients with thymoma-associated retinopathy. The good visual prognosis of our patient may be associated with well-timed intervention. Keywords Paraneoplastic retinopathy Thymoma Electroretinography Immunohistochemistry Immunosuppression therapy
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10633-020-09764-1) contains supplementary material, which is available to authorized users. K. Mizobuchi T. Hayashi S. Katagiri E. Kim T. Nakano Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
Y. Ishiba S. Watanabe Division of Molecular and Developmental Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
T. Hayashi (&) Department of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan e-mail: [email protected]
T. Furukawa Laboratory for Molecular and Developmental Biology, Institute for Protein Research, Osaka University, Osaka, Japan
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Doc Ophthalmol
Introduction Paraneoplastic retinopathy (PR) is a heterogeneous disorder characterized by progressive retinal dysfunction due to anti-retinal antibodies (ARAs) against tumor-produced proteins, which cross-react with antigenic proteins expressed in retinal photoreceptor cells [1–4]. PR
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