Paraneoplastic Vision Loss Evaluation [A Test in Focus]

Paraneoplastic vision loss occurs in people who have cancer, but the vision loss is not a result of cancer spreading to the eye.  Instead, it is related to an immune response against an underlying malignancy.  In many cases, the vision loss occurs before the cancer is diagnosed, and antibody positivity can direct the cancer search.

In this "Test in Focus" episode of the "Answers From the Lab" podcast, Andrew McKeon, M,B., B.Ch., M.D., provides an overview of Mayo Clinic Laboratories' new paraneoplastic vision loss evaluation that can help detect this disorder. The test looks for evidence of two antibodies: CRMP-5 antibody and recoverin. The presence of either one of those antibodies confirms a diagnosis of paraneoplastic vision loss.

"These are the two biomarkers that we can say are reliable and specific," Dr. McKeon says. "There are broad panels of other antibodies available for potential diagnosis of autoimmune retinopathy. But we've not included those biomarkers in this evaluation because, from our clinical practice, we have not had good experience with the specificity of those tests. And we've come across those antibodies in patients who have had non-autoimmune diagnoses."

Listen to learn more from Dr. McKeon about when the paraneoplastic vision loss evaluation should be ordered and how the results can affect patient care.

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Testing

Paraneoplastic Vision Loss Evaluation, Serum (Mayo ID: PVLE)

Recoverin-IgG Antibody by Immunoblot, Serum (Mayo Test ID: RCVBS)

Useful for:

Paraneoplastic Vision Loss Evaluation, Serum (Mayo ID: PVLE)

  • Evaluating patients with rapidly progressive vision loss where a paraneoplastic cause for vision loss (retinopathy or optic neuritis with other findings [e.g. retinitis] is suspected).
  • Evaluating patients with small cell carcinoma who develop vision loss.

Recoverin-IgG Antibody by Immunoblot, Serum (Mayo Test ID: RCVBS)

  • Evaluating patients with suspected paraneoplastic retinopathy accompanying small cell carcinoma.

Specimen Requirements

Paraneoplastic Vision Loss Evaluation, Serum (Mayo ID: PVLE)

Patient Preparation:

  • For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication.
  • This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
  • Container/Tube:
  • Preferred: Red top
  • Acceptable: Serum gel
  • Specimen Volume: 4 mL

Recoverin-IgG Antibody by Immunoblot, Serum (Mayo Test ID: RCVBS)

  • Container/Tube:
  • Preferred: Red top
  • Acceptable: Serum gel
  • Specimen Volume: 1 mL

Performance Information

Paraneoplastic Vision Loss Evaluation, Serum (Mayo ID: PVLE)

  • Day(s) and Time(s) Test Performed
    • Monday through Friday; 5 a.m., 7 a.m., 5 p.m.
    •  Saturday, Sunday; 6 a.m.
  • Analytic Time 
    • 7 days

Recoverin-IgG Antibody by Immunoblot, Serum (Mayo Test ID: RCVBS)

  • Day(s) and Time(s) Test Performed
    • Monday through Friday; 6 p.m.
  • Analytic Time 
    • 4 days
Samantha Rossi (@samantharossi)

Samantha Rossi

Samantha Rossi is a Digital Marketing Manager at Mayo Clinic Laboratories. She supports marketing strategies for product management and specialty testing. Samantha has worked at Mayo Clinic since 2019.