Antibodies in autoimmune retinopathy

ABSTRACT

Introduction: Autoimmune retinopathy (AIR) is a rare condition characterized by profound vision loss, presence of anti-retinal antibodies and association with systemic malignancy within the paraneoplastic retinopathy subtype. This review focuses on the different types of autoimmune retinopathies, their clinical features and diagnosis with emphasis on the different types of anti-retinal antibodies and their significance.

Areas covered: Cancer associated and melanoma associated retinopathy, as well as non-paraneoplastic autoimmune retinopathy, along with different anti-retinal antibodies in each subtype. A PubMed literature search was carried out using keywords: autoimmune retinopathy, cancer-associated retinopathy, melanoma-associated retinopathy, paraneoplastic retinopathy, and anti-retinal antibodies.

Expert opinion: Currently, much remains to be discovered about autoimmune retinopathy. The condition may present with varying clinical features, but commonly recognized manifestations such as photopsias, visual field defects and ERG changes have been identified. The presence of circulating anti-retinal antibodies has been considered essential to the diagnosis of AIR however no universally standardized assays exist. Additionally, the clinical validity and pathogenic role of some of the anti-retinal antibodies is yet to be determined. Immunomodulatory agents, either singly or in combination, have been tried but no therapy has shown a consistent, long-term effect.

KEYWORDS:

• Autoimmune retinopathy
• cancer associated retinopathy
• paraneoplastic retinopathy
• melanoma associated retinopathy
• anti-retinal antibodies
• non-paraneoplastic autoimmune retinopathy

Article highlights

• Focus on the different types of autoimmune retinopathies, their clinical features and diagnosis

• Emphasis on the different types of anti-retinal antibodies, their discovery and functions

• Testing currently available for anti-retinal antibodies

• Treatment with immunomodulatory agents

• Expert opinion on the need for standardized and clinically validated testing protocols for anti-retinal antibodies

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.