Autoimmune retinopathy associated with intravesical BCG therapy

Intravesical BCG is used as adjunctive immunotherapy for superficial carcinomas of the urinary bladder. Endophthalmitis and uveitis are the reported ocular complications.1–3 We report an unusual case of autoimmune retinopathy in a 58 year old man treated with intravesical BCG. The clinical features resembled CAR (cancer associated retinopathy) but there was no serum reaction to the CAR autoantigen.1 We believe that this is the first reported case of autoimmune retinopathy caused by BCG treatment. A 58 year old white man was referred with reduced vision and photophobia for 4 months following a 6 week (one instillation per week) course of intravesical BCG immunotherapy for recurrent transitional cell bladder carcinoma. On examination, after 4 months of complaints, the visual acuity was 6/24 in each eye and N18 for near. Anterior segment evaluation revealed bilateral early nuclear cataracts. The anterior chamber and vitreous were quiet. The fundus examination showed mildly attenuated arterioles (RE>LE) with a mild pigmentary disturbance in the mid-periphery. Intraocular pressure was …