Paraneoplastic Optic Neuropathy (PON) is associated with demyelination of the optic nerve.


Associated carcinomas:

(1) small cell lung cancer (most common cause)

(2) thymic carcinoma

(3) thyroid carcinoma

(4) nasopharygeal carcinoma

(5) renal carcinoma

(6) neuroblastoma


Clinical findings:

(1) The patient experiences subacute vision loss.

(2) It may be accompanied by encephalitis, cerebellar degeneration or other paraneoplastic neurologic conditions.

(3) Early there is optic disc swelling, with atrophy and pallor later.

(4) Exclusion of other causes.


Laboratory findings:

(1) The CSF shows lymphocytosis, an elevated protein, and oligoclonal bands.

(1) Anti-CV2 autoantibody (targets collapsing response-mediator protein 5, or CRMP-5) may be found in blood and/or CSF.


Treatment of the underlying tumor may reverse or slow the progression of the disorder.


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