Autoimmune retinopathy and optic neuropathy associated with enolase-positive renal oncocytoma.
Am J Ophthalmol Case Rep
; 12: 55-60, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30229140
ABSTRACT
PURPOSE:
To report a case of autoimmune retinopathy and optic neuropathy associated with an enolase-positive renal oncocytoma. OBSERVATIONS A 41-year-old man presented with subacute, painless, bilateral vision loss. On initial examination, visual acuity measured 20/125 OD and 20/1250 OS, and telangiectatic vessels were noted on the optic nerves and in the maculae. Goldmann perimetry showed bilateral, cecocentral scotomas, and electroretinography demonstrated reduced photopic and scotopic signals, concerning for autoimmune retinopathy. Serum testing showed multiple positive anti-optic nerve and anti-retinal antibodies, including to alpha-enolase. Extensive systemic workup was negative except for a large, exophytic, right renal mass. Biopsy was consistent with a benign oncocytoma, and immunohistochemical staining showed diffusely positive alpha-enolase staining. The patient was treated with a five-day course of intravenous methylprednisolone and plasmapheresis with minimal improvement. Surgical excision of the oncocytoma was performed. At 9-months post-operatively, visual acuity had improved to 20/40 OU, with corresponding improvement on visual field and electroretinography testing. CONCLUSIONS AND IMPORTANCE To our knowledge, this is the first report of autoimmune retinopathy and optic neuropathy associated with a renal oncocytoma. The case highlights the importance of a thorough systemic workup in cases of suspected autoimmune retinopathy and reminds clinicians that even tumors considered benign can have distal effects on other organs.
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Bases de dados:
MEDLINE
Tipo de estudo:
Risk_factors_studies
Idioma:
En
Revista:
Am J Ophthalmol Case Rep
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos