Autoimmune Retinopathy, Testing, and Its Controversies

Author(s):  
Luiz Roisman ◽  
Julia Dutra Rossetto ◽  
Raquel Goldhardt
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aulia Rahmi Pawestri ◽  
Niracha Arjkongharn ◽  
Ragkit Suvannaboon ◽  
Aekkachai Tuekprakhon ◽  
Vichien Srimuninnimit ◽  
...  

AbstractAutoimmune retinopathy (AIR) is a rare immune-mediated inflammation of the retina. The autoantibodies against retinal proteins and glycolytic enzymes were reported to be involved in the pathogenesis. This retrospective cohort study assessed the antiretinal autoantibody profiles and their association with clinical outcomes of AIR patients in Thailand. We included 44 patients, 75% were females, with the overall median age of onset of 48 (17–74, IQR 40–55.5) years. Common clinical presentations were nyctalopia (65.9%), blurred vision (52.3%), constricted visual field (43.2%), and nonrecordable electroretinography (65.9%). Underlying malignancy and autoimmune diseases were found in 2 and 12 female patients, respectively. We found 41 autoantibodies, with anti-α-enolase (65.9%) showing the highest prevalence, followed by anti-CAII (43.2%), anti-aldolase (40.9%), and anti-GAPDH (36.4%). Anti-aldolase was associated with male gender (P = 0.012, OR 7.11, 95% CI 1.54–32.91). Anti-CAII showed significant association with age of onset (P = 0.025, 95% CI − 17.28 to − 1.24), while anti-α-enolase (P = 0.002, OR 4.37, 95% CI 1.83–10.37) and anti-GAPDH (P = 0.001, OR 1.87, 95% CI 1.32–2.64) were significantly associated with nonrecordable electroretinography. Association between the antibody profiles and clinical outcomes may be used to direct and adjust the treatment plans and provide insights in the pathogenesis of AIR.


2010 ◽  
Vol 18 (4) ◽  
pp. 322-323 ◽  
Author(s):  
Nicole Mahdi ◽  
Lisa J. Faia ◽  
James Goodwin ◽  
Robert B. Nussenblatt ◽  
H. Nida Sen

2018 ◽  
Vol 196 ◽  
pp. 181-196 ◽  
Author(s):  
Ryo Ando ◽  
Wataru Saito ◽  
Atsuhiro Kanda ◽  
Satoru Kase ◽  
Kaoru Fujinami ◽  
...  

2017 ◽  
Vol Volume 11 ◽  
pp. 377-385 ◽  
Author(s):  
Arash Maleki ◽  
Neerav Lamba ◽  
Lina Ma ◽  
Stacey Lee ◽  
Alexander Schmidt ◽  
...  

2012 ◽  
Vol 97 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Kathryn Lynn Pepple ◽  
Michael Cusick ◽  
Glenn J Jaffe ◽  
Prithvi Mruthyunjaya

1997 ◽  
pp. 51-56
Author(s):  
John R. Heckenlively ◽  
Nata Aptsiauri ◽  
Paul A. Hargrave

2016 ◽  
Vol 4 (12) ◽  
pp. 1207-1216
Author(s):  
Pooja Bhat ◽  
Siya Huo

2016 ◽  
Vol 26 (3) ◽  
pp. 417-424 ◽  
Author(s):  
Samaneh Davoudi ◽  
Tina Ahmadi ◽  
Evangelia Papavasilieou ◽  
Ilya Leskov ◽  
Lucia Sobrin

2021 ◽  
pp. 77-79
Author(s):  
Eric R. Eggenberger ◽  
Marie D. Acierno ◽  
M. Tariq Bhatti ◽  
John J. Chen

A 75-year-old woman with a medical history of mixed connective tissue disease and breast adenocarcinoma sought care for subacute visual “haze” in both eyes characterized by light sensitivity, particularly with commercial fluorescent lighting, progressing over weeks. Visual acuity was 20/40 in each eye. The pupils were equal in size with no relative afferent pupillary defect but were sluggishly reactive to light. Automated perimetry documented peripheral constriction in both eyes. Ocular motility was normal. Ophthalmoscopy showed mild retinal pigment epithelial changes in both maculae with normal optic nerves. Optical coherence tomography showed macular thinning in both eyes. Findings of fundus autofluorescence were normal. Serum testing documented the presence of 3 retinal antibodies, against 30-, 36-, and 46-kDa proteins. A paraneoplastic panel was negative except for low-level ganglionic (alpha 3) acetylcholine receptor autoantibody positivity, which was interpreted as nonspecific autoimmunity. Electroretinography indicated severely decreased scotopic and photopic a and b waves. A diagnosis of paraneoplastic or nonparaneoplastic autoimmune retinopathy was made, consistent with the clinical presentation, optical coherence tomography and electroretinography findings, and the presence of retinal antibodies. There are no established evidence-based guidelines to assist treatment decisions in autoimmune retinopathy, although several lines of therapy have been advocated. No specific immunosuppressive therapy was undertaken in this case. However, if her vision had continued to rapidly worsen over time, empiric immunotherapy would have been instituted. Autoimmune retinopathy includes paraneoplastic and nonparaneoplastic forms. The best-characterized autoimmune retinopathy phenotype is cancer-associated retinopathy. Cancer-associated retinopathy typically presents with subacute, painless, bilateral (although asymmetry has been described) vision loss that is progressive over weeks to months, reflecting both rod and cone dysfunction in most patients. Visual symptoms precede recognition of an underlying cancer in approximately 50% of cases.


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