Survey of Ophthalmology
Volume 55, Issue 2 , Pages 169-173, March 2010

Glazed (Vision) and Confused

  • Heather E. Moss, MD, PhD

      Affiliations

    • Division of Neuro-Ophthalmology, Departments of Neurology and Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
    • Corresponding Author InformationReprint address: Heather E. Moss, MD, PhD, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
    • ,
  • Grant T. Liu, MD

      Affiliations

    • Division of Neuro-Ophthalmology, Departments of Neurology and Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
    • ,
  • Josep Dalmau, MD, PhD

      Affiliations

    • Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

published online 05 October 2009.

Peter Savino and Helen Danesh-Meyer, Editors

Abstract 

A 60-year-old man presented with vitritis and optic neuropathy in the setting of headaches and behavioral changes. MRI brain revealed bilateral temporal lobe inflammation consistent with limbic encephalitis. He was subsequently diagnosed with small cell lung cancer with a paraneoplastic syndrome characterized by CRMP5 IgG as a cause of his symptoms. His visual symptoms improved markedly after anti-inflammatory therapy and his cognitive symptoms were mildly better following systemic chemotherapy. The clinical presentation, pathophysiology, and therapy of CRMP5 associated paraneoplastic syndromes are discussed.

Key words: CRMP5, limbic encephalitis, optic neuropathy, paraneoplastic syndrome, vitritis

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 The authors wish to thank Dr. Darma Ie for performing the retina evaluation, biopsying the vitreous, and providing the fundus photos. The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(09)00187-8

doi:10.1016/j.survophthal.2009.03.008

Survey of Ophthalmology
Volume 55, Issue 2 , Pages 169-173, March 2010

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