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83歳男性が左眼の白内障手術を受けた。右眼には8年前に白内障手術を受けている。7年前に胃悪性リンパ腫のために胃全摘手術を受けた。左眼手術の翌日から両眼の視力が急激に低下して当科を受診した。視力は左右とも光覚弁であった。両眼の網膜動脈が狭細化し,乳頭が蒼白で,網膜電図が消失していた。全身検査で肺腫瘍が発見され,生検で肺大細胞癌と診断された。抗リカバリン抗体が陽性であり,悪性腫瘍随伴網膜症(CAR)の診断が確定した。肺大細胞癌に対しては抗癌薬が投与された。治療開始から18か月後の現在まで視機能の改善はない。
A 83-year-old male received cataract surgery in his left eye. He had undergone cataract surgery in his right eye 8 years before. Total gastrectomy had been performed for malignant lymphoma 7 years before. Sudden visual loss occurred on day 2 of surgery in the left eye. When seen the same day, his visual acuity was light perception in either eye. Both eyes showed attenuated retinal vessels and pallor of optic disc. Electroretinogram was extinguished. Systemic examinations led to detection of lung cancer. It was identified as large-cell carcinoma by biopsy. He was diagnosed with cancer-associated retinopathy(CAR)after antirecoverin antibody was found positive. He was treated by anticancer chemotherapy. No improvement in visual function has set in during 18 months until present.
Rinsho Ganka(Jpn J Clin Ophthalmol)60(8):1467-1470, 2006
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