Evidence map›Paper›PMID 34327032›Full record

ArticleCase reports in ophthalmological medicine2021

Vision Improvement after Osimertinib Treatment in Paraneoplastic Optic Neuropathy Associated with Lung Adenocarcinoma.

Masaomi Kubota, Nobumasa Tamura, Takaaki Hayashi, Euido Nishijima, Haruhiko Yanagisawa, Akira Kojima, Tadashi Nakano

Open access · goldAbstract readCase Reports
In one paragraph

Article in Case reports in ophthalmological medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.1field-weighted citation impact, top 53% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Masaomi KubotaDepartment of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan.ORCID https://orcid.org/0000-0002-2314-8767
Nobumasa TamuraDepartment of Respiratory Medicine, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan.
Takaaki HayashiDepartment of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan.ORCID https://orcid.org/0000-0002-1535-0279
Euido NishijimaDepartment of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan.
Haruhiko YanagisawaDepartment of Respiratory Medicine, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan.
Akira KojimaDepartment of Respiratory Medicine, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan.
Tadashi NakanoDepartment of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan.
Jikei University School of Medicine · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Treatments for paraneoplastic optic neuropathy (PON), a tumor-related autoimmune disease, include immunosuppression, plasma exchange, and immunoglobulin therapies, as well as treatment of the underlying disease. Herein, we describe the clinical course of an older adult patient with PON whose loss of vision improved after switching between epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatments for cancer. A 76-year-old woman, who had been treated with gefitinib for lung adenocarcinoma for two years, presented with acute bilateral visual disturbances. Her decimal best-corrected visual acuity (BCVA) was 0.3 in the right eye (RE) and 0.7 in the left eye (LE). Slit-lamp examination and funduscopy showed no abnormal findings. Two weeks later, her BCVA decreased to 0.2 in the RE and 0.01 in the LE. Goldman's perimetry showed a defect in the lower nasal RE and extensive visual-field loss in the LE. Single-flash electroretinograms showed normal amplitudes. Magnetic resonance imaging revealed left optic neuritis and showed neither metastatic cancer nor multiple sclerosis. Pattern-reversal visual evoked potentials showed decreased P100 amplitudes in both eyes (BE). Based on a diagnosis of PON from clinical findings, methylprednisolone pulse treatment was administered. However, her BCVA became no light perception in BE two months after the first visit. Because the tumor tissue was found to be positive for the EGFR T790M resistance mutation by bronchoscopy, the EGFR-TKI treatment was changed to osimertinib, decreasing the size of the lung cancer lesions. Her BCVA improved to hand motion in BE. Her final BCVA was 0.01 in the RE, counting fingers 10 cm in the LE. She died at the age of 79 years. To our knowledge, no reports have shown improvement in BCVA in patients with PON after changing EGFR-TKI treatments. This report indicates that some patients may develop severe visual dysfunction without early treatment for the primary tumor.

Identifiers

PMID34327032
PMCPMC8302396
OpenAlexW3184341466

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.