Paraneoplastic Cone Dysfunction: An Unusual Visual Remote Effect of Cancer

Abstract

The paraneoplastic retinopathy syndromes include cancer-associated retinopathy (CAR), melanoma-associated retinopathy, ganglion cell neuronopathy, and diffuse uveal melanocytic proliferation. We describe a patient with an unusual visual remote effect of cancer, an acquired cone dysfunction syndrome. 1,2 Report of a Case. An 87-year-old demented nursing home resident was referred for evaluation of poor vision for the preceding several months. Her visual acuity was normal when last seen by her optometrist several years earlier. She was unaware of scotomas or loss of color perception, but admitted to photosensitivity and better ability to see at twilight. She had a history of Hurthle cell adenocarcinoma of the thyroid, diagnosed 2 months before evaluation; gastric adenocarcinoma, diagnosed 11 months before evaluation; and colon adenocarcinoma, diagnosed 4 months before evaluation; all of these were treated surgically. She had not received chemotherapy for any of these malignant tumors. Her medications included levothyroxine sodium for hypothyroidism, and quinidine