Uveitis in Paraneoplastic Syndrome: about 4 Cases

Abstract

Paraneoplastic ocular disorders are rare conditions that may precede or accompany a cancer diagnosis. These disorders result from an autoimmune response that targets tumor-associated antigens aberrantly expressed in ocular tissues, affecting the retina, optic nerve, and vasculature. Common types of paraneoplastic ocular disorders include cancer-associated retinopathy, paraneoplastic optic neuropathy, chronic uveitis, and melanoma-associated retinopathy. Diagnosis is particularly challenging in elderly patients with ophthalmic comorbidities, as the eye is not directly affected by the tumor. The diagnosis relies on ophthalmologic examinations, ocular ultrasound, and autoantibody testing to facilitate oncological evaluation. Management primarily focuses on treating the tumor, often in conjunction with immunomodulatory therapies. While corticosteroids may help reduce inflammation, their efficacy can vary. A multidisciplinary approach that includes ophthalmologists, oncologists, geriatricians, and internists is essential for optimizing patient outcomes. This article presents four cases of paraneoplastic uveitis associated with bladder cancer, thyroid cancer, multiple myeloma, and monoclonal gammopathy, emphasizing the diagnostic complexity of this condition.