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Paraneoplastic optic disc oedema and retinal periphlebitis associated with pineal germinoma
  1. Farzin Forooghian1,
  2. Hall F Chew1,
  3. Rajeev H Muni1,
  4. Grazyna Adamus2,
  5. James M Drake3,
  6. J Raymond Buncic4
  1. 1Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
  3. 3Department of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
  4. 4Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to: Dr F Forooghian Room 10128, Elm Wing, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8; farzin.forooghian{at}utoronto.ca

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Cancer-associated retinopathy (CAR) is a well-described paraneoplastic syndrome that is mediated by antiretinal antibodies.1 Inflammatory changes such as optic disc oedema and retinal vasculitis have not been reported in CAR. Although CAR has been reported with various tumours, there have been no reports of paraneoplastic retinopathy or optic neuropathy with pineal gland tumours.2 We report a case of a novel paraneoplastic syndrome consisting of bilateral disc oedema and retinal periphlebitis in a patient with pineal gland germinoma.

Case report

A 14-year-old boy with a pineal gland tumour was referred because of blurred vision. Best-corrected visual acuity was 20/20 in the right eye and 20/20 in the left eye. Examination of the pupils and eye movements verified the presence of a dorsal midbrain syndrome. Anterior segment examination and intraocular pressures were normal. Dilated fundus examination showed bilateral …

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