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Title

Sudden bilateral visual loss related to a Cancer-Associated Retinopathy (CAR): An atypical presentation.

Purpose	To report the case of a 56-year old woman without any prior history of cancer, who was referred for a rapid bilateral visual loss and ultimately diagnosed with a neuroendocrine tumor of the lung associated to cancer-associated retinopathy (CAR).
Methods	Case-report and review of literature.
Results	The patient presented with rapid visual loss in both eyes over ten days. Visual acuity was LP OD, HM OS. Anterior and posterior biomicroscopy revealed anterior uveitis with vitritis in both eyes. Bilateral optic disc pallor, arteriolar attenuation and disappearance of the foveal reflect were documented. OCT demonstrated major photoreceptor layer atrophy. Fluorescein angiography was unremarkable. Blood analyses were normal. ERG showed flat responses on both scotopic and photopic conditions. In order to rule out CAR syndrome, chest CT was ordered and revealed a right lung tumor with mediastinal lymphadenopathy. Histopathogical examination confirmed the diagnosis of large cell neuroendocrine carcinoma of the lung. Dosage of anti-recoverin antibodies was not performed. Despite intensive IV corticosteroid therapy and disappearance of the inflammatory signs, the final vision was LP in both eyes within two weeks.
Conclusion	The two-week bilateral loss of vision in our patient is atypical for patient diagnosed with CAR syndrome as well as the neuroendocrine characteristics of the primary tumor.

Author 1

Last name	NOEL
Initials	A
Department	Université Catholique de Louvain
City	Bruxelles

Author 2

Last name	BOSCHI
Initials	A
Department	Université Catholique de Louvain
City	Bruxelles

Author 3

Last name	DE POTTER
Initials	P
Department	Université Catholique de Louvain
City	Bruxelles