Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody.
Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody.
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DOI：
10.2147/opth.s55124
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Terasaki H
中科院分区：
文献类型：
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作者：
Ueno S;Ito Y;Maruko R;Kondo M;Terasaki H
本文的目的是报告1例癌症相关性视网膜病变患者的脉络膜萎缩，该患者具有抗瞬时受体电位阳离子通道亚家族成员1(TRPM1)的自身抗体。一位69岁男性于2010年7月来我科就诊，主诉双眼视力模糊及夜盲。全场视网膜电信号为负性，提示双极细胞功能障碍。一般体格检查显示为肺小细胞癌，患者血清的免疫印迹显示有抗TRPM1的自身抗体。由于抗TRPM1自身抗体，我们诊断这位患者患有癌症相关性视网膜病变和视网膜双极功能障碍。从第一次就诊开始，我们对他进行了两年多的跟踪调查，他的症状没有改变。然而，与眼底脉络膜色素减少一致，光谱域光学相干断层扫描显示脉络膜厚度在两年的随访期内减少了约三分之一。我们认为这例渐进性脉络膜萎缩是由抗TRPM1的自身抗体直接引起的，因为TRPM1不仅在双极细胞上表达，而且在黑素细胞上也表达。这些结果表明，抗TRPM1抗体阳性的副肿瘤性视网膜病变患者存在视网膜双极功能障碍，应注意其脉络膜厚度。
The purpose of this paper is to report choroidal atrophy in a patient with cancer-associated retinopathy who had autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1). A 69-year-old man visited our clinic in July 2010 with complaints of blurred vision and night blindness in both eyes. The full-field electroretinograms were negative type, indicating ON bipolar cell dysfunction. General physical examination revealed small cell carcinoma of the lung, and Western blot of the patient’s serum showed autoantibodies against TRPM1. We diagnosed this patient with cancer-associated retinopathy and retinal ON bipolar dysfunction due to anti-TRPM1 autoantibody. We followed him for more than 2 years from the initial visit and his symptoms have not changed. However, consistent with the choroidal hypopigmentation of the fundus, spectral domain optical coherence tomography showed a decrease in choroidal thickness of about one third over a 2-year follow-up period. We suggest that this case of gradually progressive choroidal atrophy was caused by the autoantibody against TRPM1 directly, because TRPM1 is expressed not only on ON bipolar cells but also on melanocytes. These findings indicate that we should be aware of choroidal thickness in patients with paraneoplastic retinopathy who have retinal ON bipolar dysfunction with the anti-TRPM1 antibody.