Bilateral autoimmune optic neuritis and vitreitis related to CRMP-5-IgG: intravitreal triamcinolone acetonide therapy of four eyes

Eye (Lond). 2008 Sep;22(9):1191-3. doi: 10.1038/sj.eye.6702959. Epub 2007 Aug 24.

Abstract

Purpose: To report the vision outcome following intravitreal triamcinolone acetonide (IVTA) as adjunctive therapy in four eyes of two patients with paraneoplastic autoimmune optic neuritis and vitreitis related to CRMP (Collapsin-Response-Mediator Protein)-5-IgG.

Design: Retrospective case series.MethodsChart review of four eyes.

Results: Preoperative visions were: patient 1, 20/50 OD, 20/25 OS; patient 2, counting fingers (CF) at two feet OD, and CF at three feet OS. At last follow-up, the postoperative visions were 20/40, 20/50 and 20/200, 20/60, respectively. All signs of optic disc swelling and vitreitis had abated.

Conclusions: Use of IVTAin paraneoplastic autoimmune optic neuritis and vitreitis related to CRMP-5-IgG was followed by a marked decrease in inflammation and stabilization or improvement of vision. These observations support this form of adjunctive therapy in patients whose intraocular pathology is attributed to paraneoplastic autoimmunity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Diseases of the Nervous System / drug therapy*
  • Autoimmune Diseases of the Nervous System / immunology
  • Eye Diseases / drug therapy
  • Eye Diseases / immunology
  • Female
  • Humans
  • Hydrolases
  • Immunoglobulin G / immunology
  • Immunosuppressive Agents / administration & dosage*
  • Male
  • Microtubule-Associated Proteins
  • Middle Aged
  • Nerve Tissue Proteins / immunology
  • Optic Disk / immunology
  • Optic Neuritis / drug therapy*
  • Optic Neuritis / immunology
  • Paraneoplastic Syndromes / drug therapy*
  • Paraneoplastic Syndromes / immunology
  • Triamcinolone Acetonide / administration & dosage*
  • Vitreous Body

Substances

  • Immunoglobulin G
  • Immunosuppressive Agents
  • Microtubule-Associated Proteins
  • Nerve Tissue Proteins
  • DPYSL5 protein, human
  • Hydrolases
  • Triamcinolone Acetonide