Background: Specific cross-reacting autoimmunity against recoverin or collapsin response mediator protein\r\n(CRMP)-5 is known to cause cancer-associated retinopathy or paraneoplastic optic neuropathy, respectively.\r\nWe report a rare case with small cell lung carcinoma developing bilateral neuroretinitis and unilateral focal outer\r\nretinitis positive for these antibodies.\r\nCase presentation: A 67-year-old man developed bilateral neuroretinitis and foveal exudation in the right eye.\r\nOptical coherence tomography showed a dome-shaped hyperreflective lesion extending from inner nuclear layer to\r\nthe photoreceptor layer at the fovea in the right eye. Single-flash electroretinography showed normal a-waves in\r\nboth eyes and slightly reduced b-wave in the left eye. Results of serological screening tests for infection were within\r\nnormal limits. The patient�s optic disc swelling and macular exudation rapidly improved after oral administration of\r\nprednisolone. Systemic screening detected lung small cell carcinoma and systemic chemotherapy was initiated.\r\nImmunoblot analyses using the patient�s serum detected autoantibodies against recoverin, CRMP-5, and a-enolase,\r\nbut not carbonic anhydrase II. Neuroretinitis once resolved after almost remission of carcinoma on imaging but it\r\nrecurred following the recurrence of carcinoma.\r\nConclusions: The development of neuroretinitis in this cancer patient with anti-retinal and anti-optic nerve\r\nantibodies depended largely on the cancer activity, suggesting the possible involvement of paraneoplastic\r\nmechanisms. Patients with paraneoplastic optic neuropathy and retinopathy are likely to develop autoimmune\r\nresponses against several antigens, thus leading to various ophthalmic involvements.
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