Paraneoplastic retinopathy associated with metastatic cutaneous melanoma of unknown primary site

Purpose: To describe further the clinical and immunological features of cutaneous melanoma-associated retinopathy, which is an infrequent form of paraneoplastic syndrome. Methods: We studied the salient clinical and immunological aspects of a 66-year-old man with metastatic cutaneous melanoma to lymph nodes of unknown primary site who developed melanoma-associated retinopathy. Results: There was gradual loss of vision in the left eye, Colour vision and night vision were not affected, Visual fields showed arcuate defects, A full-field electroretinogram demonstrated attenuation of the b-wave amplitude in the left eye, The a-wave was intact. Indirect immunofluorescence techniques showed that the antibody reactions took place mainly in the outer plexiform layer of the retina. Conclusions: Bipolar cells seem to be the target in melanoma-associated retinopathy, Contrary to previous reports, night blindness may not be a universal finding.