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Br J Ophthalmol 89:927-928 doi:10.1136/bjo.2004.065359
  • Letter

Autoimmune retinopathy associated with intravesical BCG therapy

  1. S Sharan1,
  2. C E Thirkill2,
  3. J R Grigg3
  1. 1Save Sight Institute, University of Sydney, Department of Ophthalmology, Sydney Eye Hospital, 8 Macquarie Street, Sydney 2000, Australia
  2. 2Department of Ophthalmology, UC Davis Health System, University of California, Sacramento, CA 95817, USA
  3. 3Save Sight Institute, University of Sydney, Department of Ophthalmology, Sydney Eye Hospital, 8, Macquarie Street, Sydney 2000, Australia
  1. Correspondence to: Sapna Sharan Save Sight Institute, University of Sydney, Department of Ophthalmology, Sydney Eye Hospital, 8 Macquarie Street, Sydney 2000, Australia; sapnasdyahoo.co.uk
  • Accepted 1 January 2005

Intravesical BCG is used as adjunctive immunotherapy for superficial carcinomas of the urinary bladder. Endophthalmitis and uveitis are the reported ocular complications.1–3 We report an unusual case of autoimmune retinopathy in a 58 year old man treated with intravesical BCG. The clinical features resembled CAR (cancer associated retinopathy) but there was no serum reaction to the CAR autoantigen.1 We believe that this is the first reported case of autoimmune retinopathy caused by BCG treatment.

Case report

A 58 year old white man was referred with reduced vision and photophobia for 4 months following a 6 week (one instillation per week) course of intravesical BCG immunotherapy for recurrent transitional cell bladder carcinoma. On examination, after 4 months of complaints, the visual acuity was 6/24 in each eye and N18 for near. Anterior segment evaluation revealed bilateral early nuclear cataracts. The anterior chamber and vitreous were quiet. The fundus examination showed mildly attenuated arterioles (RE>LE) with a mild pigmentary disturbance in the mid-periphery. Intraocular pressure was …