A case of melanoma-associated retinopathy with autoantibodies against TRPM1

Doc Ophthalmol. 2020 Dec;141(3):313-318. doi: 10.1007/s10633-020-09772-1. Epub 2020 May 29.

Abstract

Purpose: To report a case of melanoma-associated retinopathy (MAR) with autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1) with asymmetric severe vision loss.

Methods: We evaluated a patient with heel skin melanoma showing progressive vision loss in both eyes confirmed with a baseline ophthalmic examination, fluorescein angiography, spectral domain optical coherence tomography (OCT), visual field test, and full-field electroretinogram (ERG). Immunofluorescence assays and western blot analysis revealed autoantibodies in the patient's serum.

Results: The patient's best-corrected visual acuities were 20/50 in the right eye and hand motion in the left eye. Visual field test showed severely depressed visual fields especially in the left eye. Fluorescein angiography and OCT revealed extrafoveal choroidal neovascularization in the left eye. The patient had an electronegative ERG, suggesting MAR, and autoantibodies against TRPM1 and aldolase C were detected in the patient's blood sample.

Conclusions: The clinical features of MAR patients with positive anti-TRPM1 autoantibodies can be manifested as severe vision loss, and the identification of autoantibodies can be helpful for confirming the diagnosis.

Keywords: Aldolase C; Antiretinal autoantibody; Melanoma-associated retinopathy; TRPM1.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / blood*
  • Blotting, Western
  • Electroretinography
  • Fluorescein Angiography
  • Humans
  • Male
  • Melanoma / immunology*
  • Melanoma / pathology
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Paraneoplastic Syndromes, Ocular / immunology*
  • Paraneoplastic Syndromes, Ocular / pathology
  • Retina / physiopathology*
  • Skin Neoplasms / immunology*
  • Skin Neoplasms / pathology
  • TRPM Cation Channels / immunology*
  • Tomography, Optical Coherence
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology

Substances

  • Autoantibodies
  • TRPM Cation Channels
  • TRPM1 protein, human