A 53 year old male with leukemia presented with optic disc pallor, attenuated retinal vessels and peripheral visual field loss confirmed on formal testing. Anti-retinal antibodies were detected by immunohistochemistry confirming the diagnosis of cancer- associated retinopathy (CAR). Hematology continued systemic chemotherapy but did not recommend systemic immune suppression as a safe treatment for the paraneoplastic eye disease. The patient received a single injection in the more severely affected eye of intravitreal triamcinolone and had initial improvement then ultimately stabilization of the visual field loss and optic nerve pallor without any side effects from the intraocular steroid injection. This case demonstrates that intraocular corticosteroid can be a safe, efficacious, local treatment option for cancer associated retinopathy.
Author(s): Justin Yamanuha, Misty Watters