What is it about?
This is a case report of cancer associated retinopathy in association with ampullary pancreatic cancer. The eye exam and testing ultimately lead to an earlier diagnosis and treatment of the patient's pancreatic cancer. The patient made a good recovery, with no progression of her retinopathy.
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Why is it important?
This is important because eye manifestations can be the only indication of an occult/hidden cancer, and a fast diagnosis can be potentially life-saving. Eye doctors need to be weary of cancer-associated retinopathy as a possible diagnosis in instances where there is unexplained or subacute visual loss of visual field changes. It can present with no obvious findings on examination, but electrodiagnostic testing is critical to evaluate retinal function for early diagnosis of this disease.
Perspectives
As eye doctors, we often get cases where a patient comes in with a reduction in vision, but there "isn't anything obvious" to be seen. In the context of a busy clinic, it might be easy to disregard this and reassure the patient that nothing is wrong. In this case, the patient was also quite anxious, which makes things even more difficult to judge. This case highlighted to me that the possibility of cancer-associated retinopathy should always be considered in instances where there is a subacute deterioration in visual acuity and/or fields, and it is always in the back of my mind. I hope that the case report is though-provoking for those who work in the fascinating field of the Eye.
Nima Ghadiri
University of Cambridge
Read the Original
This page is a summary of: Cancer-associated retinopathy in ampullary pancreatic cancer, BMJ Case Reports, November 2019, BMJ,
DOI: 10.1136/bcr-2019-231444.
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