■ Autoimmune retinopathies should be included in the neuroophthalmic differential diagnosis for subacute vision loss with
minimal fundus changes.
■ Particularly relevant are paraneoplastic retinopathies [cancer-associated retinopathy (CAR), melanoma-associated retinopathy
(MAR), bilateral diffuse uveal melanocytic proliferation (BDUMP)], autoimmune-related retinopathy and optic neuropathy (ARRON),
and the acute outer retinopathies with blind spot enlargement [acute idiopathic blind spot enlargement (AIBSE), multiple evanescent
white dot syndrome (MEWDS), and acute zonal occult outer retinopathy (AZOOR)].
■ Important historical factors include history of cancer, particularly small cell lung cancer or cancers of the reproductive
tract, presence of photopsias, night blindness, or decreased vision in bright light.
■ Subtle fundus changes may be present, including multiple evanescent white dots or foveal granularity in MEWDS, subtle red
retinal pigment epithelium lesions in BDUMP, narrow retinal vessels in CAR or MAR, or mild disc edema in AIBSE or AZOOR.
■ Automated visual fields, electroretinography, fluorescein angiography, and ocular coherence tomography can help to diagnose
these retinopathies.