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Grazyna Adamus, Dongseok Choi, Jade Schiffman; Prevalence of Anti-Retinal Autoantibodies in Women with Gynecological Cancers with and without Cancer Associated Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):357.
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The goal of the study was to examine the presence of serum anti-retinal autoantibodies (AAbs) in cancer associated retinopathy (CAR) patients with different types of gynecological cancers in comparison to healthy women and patients with similar cancers but without visual problems.
Sera from repositories at MD Anderson Medical Center and OHSU represented 36 women with an average age of 58 years with CAR and gynecological cancers, including endometrial, cervical, ovarian, and fallopian tubes cancers. Patients mostly presented with progressive loss of vision, with reduced visual acuity, color impairment and photosensitivity and an abnormal ERG. For comparison, sera from 90 patients with endometrial, cervical, ovarian, and fallopian tubes cancers without symptoms of CAR as well as 65 age-matched healthy women were analyzed. Sera were tested for the presence of anti-retinal autoantibodies by western blotting and the P value was calculated from the Fisher's exact test.
Anti-retinal AAbs occurred in women with gynecologic malignancies with and without CAR as well as in the age matched controls. Women with gynecologic tumors and CAR had a higher proportion (81%) of seropositivity compared with women with gynecologic malignancies without clinical symptoms of CAR (60%) and healthy normal controls (58%). Four AAbs specific to enolase, carbonic anhydrase II, recoverin and GAPDH were predominant in patients’ sera. Anti-alpha enolase AAbs were detected in 39% CAR patients and 13% control subjects (p=0.006). Anti-CAII antibodies were prevalent in women without CAR (p=0.039). Anti-recoverin AAbs were present only in endometrial CAR (p=0.001). Anti-GAPDH antibodies were significantly higher in patients with CAR compared to patients without CAR (p=0.028). In this cohort, cancer was always diagnosed before diagnosis of retinopathy with latency from 2 months to 30 years with the longest interval in cervical malignancies (on average 21 years). The diagnosis of the ovarian and endometrial cancers and CAR often coincided.
CAR associated with different type of gynecological malignancies presented different anti-retinal AAbs and ocular symptoms that manifested months to years after the initial tumor diagnosis. Anti-enolase and anti-recoverin AAbs occurred more often in women with CAR than controls.
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