Paraneoplastic optic neuropathy features
Reviewed by Jonathan Chan

This is a retrospective review of seven patients diagnosed with paraneoplastic optic neuropathy (PON) between January 2015 and June 2017. Five patients had a history of primary malignancy, including papillary thyroid carcinoma, type B thymoma, testicular seminoma and lung carcinoma. Five patients presented with simultaneous or early sequential bilateral eye involvement. Severe visual loss (<0.1) was seen in 10/13 eyes; 6/7 with bilateral involvement, and 6/13 eyes had disc oedema. Paraneoplastic-associated (PNS) antibodies were positive in all patients – three for anti-antiphilphysin, one for anti-PNMA2 (Ma2/Ta), one for anti-Yo, one for anti-Ma2 and one for anti-CV2. Two with positive PNS antibodies but the solid primary malignancy had not been found. The authors commented that this group of patients have a poor visual prognosis and insensitive to methylprednisolone treatment, and recommended larger sample population and longer follow-up.

Distinct clinical characteristics of paraneoplastic optic neuropathy.
Xu Q, Du W, Zhou H, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2019;103:797-801.