A slow-release dexamethasone implant for cancer-associated retinopathy

Chaves, Leandro; Albuquerque, Marina L de; Schnorr, Amanda; Cyrino, Francyne Veiga Reis; Habib, Maria Lúcia; Messias, André; Corrêa, Zélia M.; Jorge, Rodrigo

doi:10.5935/0004-2749.20230006

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…In agreement with previous case reports on MAR, our patient responded positively to intraocular dexamethasone implants, which restored the normal ffERG and correlated with signi cant improvement in visual elds (Figure 2, Supplementary Figure 1) (Chaves et al, 2022;Patel et al, 2018;Xie et al, 2019). While ffERG b-wave amplitudes appeared maximally restored during June through August 2022 (Figure 2), high levels of TRPM1 autoantibodies remained detectable in the patient's serum during this same period (Figure 3, Figure 4), con rming that circulating TRPM1 autoantibodies alone are not su cient to cause visual impairment (Duvoisin et al, 2019).…”

Section: Discussionsupporting

confidence: 92%

Case Report: Longitudinal Evaluation and Treatment of a Melanoma-Associated Retinopathy Patient

Mosavi-Hecht,

Yang,

Heyer

et al. 2024

Preprint

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Melanoma-associated retinopathy (MAR) is a paraneoplastic syndrome associated with cutaneous metastatic melanoma in which patients develop vision deficits that include reduced night vision, poor contrast sensitivity, and photopsia. MAR is caused by autoantibodies targeting TRPM1, an ion channel found in melanocytes and retinal ON-bipolar cells (ON-BCs). The visual symptoms arise when TRPM1 autoantibodies enter ON-BCs and block the function of TRPM1, thus detection of TRPM1 autoantibodies in patient serum is a key criterion in diagnosing MAR. Electroretinograms are used to measure the impact of TRPM1 autoantibodies on ON-BC function and represent another important diagnostic tool for MAR. To date, MAR case reports have included one or both diagnostic components, but only for a single time point in the course of a patient’s disease. Here, we report a case of MAR supported by longitudinal analysis of serum autoantibody detection, visual function, ocular inflammation, vascular integrity, and response to slow-release intraocular corticosteroids. Integrating these data with the patient’s oncological and ophthalmological records reveals novel insights regarding MAR pathogenesis, progression, and treatment, which may inform new research and expand our collective understanding of the disease. In brief, we find TRPM1 autoantibodies can disrupt vision even when serum levels are barely detectable by western blot and immunohistochemistry; intraocular dexamethasone treatment alleviates MAR visual symptoms despite high levels of circulating TRPM1 autoantibodies, implicating antibody access to the retina as a key factor in MAR pathogenesis. Elevated inflammatory cytokine levels in the patient’s eyes may be responsible for the observed damage to the blood-retinal barrier and subsequent entry of autoantibodies into the retina.

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Section: Discussionsupporting

confidence: 92%

Case Report: Longitudinal Evaluation and Treatment of a Melanoma-Associated Retinopathy Patient

Mosavi-Hecht,

Yang,

Heyer

et al. 2024

Preprint

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Anti-TRPM1 autoantibody-positive unilateral melanoma associated retinopathy (MAR) triggered by immunotherapy recapitulates functional and structural details of TRPM1-associated congenital stationary night blindness

Cohen,

Sumaroka,

Paulos

et al. 2024

American Journal of Ophthalmology Case Reports

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Intravitreal Dexamethasone Implant in Autoimmune Retinopathy

Bordin

Mengue

Vilela

2023

Case Reports in Ophthalmological Medicine

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Purpose. To describe the results of an intravitreal dexamethasone implant in managing autoimmune retinopathy (AIR). Methods. Two patients affected by AIR underwent intravitreal dexamethasone implantation and were followed by ocular coherence tomography, visual fields, and electroretinography. Results. The patients showed an interruption of the functional losses and remained stable with semestral injections. Conclusion. AIR is a complex condition with no standard treatment. The use of dexamethasone could be a valid option.

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A slow-release dexamethasone implant for cancer-associated retinopathy

Cited by 3 publications

References 7 publications

Case Report: Longitudinal Evaluation and Treatment of a Melanoma-Associated Retinopathy Patient

Case Report: Longitudinal Evaluation and Treatment of a Melanoma-Associated Retinopathy Patient

Anti-TRPM1 autoantibody-positive unilateral melanoma associated retinopathy (MAR) triggered by immunotherapy recapitulates functional and structural details of TRPM1-associated congenital stationary night blindness

Intravitreal Dexamethasone Implant in Autoimmune Retinopathy

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