Paraneoplastic Night Blindness With Malignant Melanoma

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A 69-year-old hyperopic man developed acute night blindness and hallucinations of shimmering lights three years after resection of a cutaneous malignant melanoma. There were no metastatic ocular lesions and he had received no medications. His electroretinogram showed abnormalities comparable to those of patients with congenital stationary night blindness with myopia. Metastatic melanoma was recognized several months later. His electroretinographic responses were also identical to those ascribed to vincristine therapy in a previously described patient with malignant melanoma. Our findings showed that acquired night blindness, apparently resulting from interruption of intraretinal rod signal transmission, can be a paraneoplastic effect of a malignant melanoma.

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This study was supported in part by Specialized Research Center grant P50EY02014 from the National Eye Institute and in part by the Retinitis Pigmentosa Foundation Fighting Blindness, Baltimore.

Reprint requests to Eliot L. Berson, M.D., Berman-Gund Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114.

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