Topic outline

  • Grand Rounds

    A patient presented to the uveitis clinic for progressively decreasing vision in both eyes. She first noticed difficulty in seeing at night and later also developed flashes and halos of light. Best-corrected visual acuity was 20/40 in the right eye and 20/80 in the left eye with normal intraocular pressures. Anterior segment exam was unremarkable and posterior exam revealed attenuated vasculature and pigmentary mottling in the periphery. Optical coherence tomography showed outer retinal and photoreceptor loss sparing the fovea corresponding with autofluorescence showing a hyperautofluoresence ring in the macula. Humphrey visual field testing showed visual field constriction in both eyes. Electroretinogram showed decreased rod and cone function. Anti-retinal antibody panel revealed positive carbonic anhydrase, tubilin and arrestin antibodies. The patient underwent systemic work-up for malignancy which was negative and was subsequently diagnosed with non-paraneoplastic autoimmune retinopathy. She was treated with local steroid injection, IVIG and Rituximab, with stabilization of her disease.

    Presentation Date: 02/15/2024
    Issue Date: 02/23/2024