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N Yoshida, K Ohta, T Kurokawa, T Kikuchi, N Yoshimura; Autoimmune Retinopathy: Antibodies in the Serum of a Patient Reacts to Retina-specific Protein in the Inner and Outer Plexiform Layers of Monkey Retina . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2227.
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Purpose:To report the clinical, electrophysiologic, and immunologic features of a patient with progressive loss of vision resembling cancer-associated retinopathy in the absence of systemic malignancies. Methods:Ophthalmic examination and visual function testing included Goldmann perimetry and electroretinography (ERG) were performed. Western blot analysis of the patient's serum (diluted 1:1000) against rat proteins of retina, brain, and liver and immunohistochemical analysis of the serum of the patient (diluted 1:100) using deparaffinized section of monkey retina was also performed. Results:A 26-year-old woman had visual loss gradually for about 8 years. In June 2000, at her first visit of our hospital, her visual acuity was 6/20 OD and 4/20 OS. Goldmann perimetry results appeared bilateral central scotomas, and flicker ERG revealed poor response. Ophthalmic examination showed mild vitreous opacity and vasculitis in both peripheral fundus. Cystoid macular edema was also present in her right eye. She had no family history and past history. Systemic examination did not show any signs of malignancies. In November 2001, her visual acuity was 6/20 OD and 4/20 OS. Western blot analysis revealed that the serum contained autoantibodies against about 36-kDa retinal proteins of rat, although no immuno-reactive band in the proteins of brain and liver were found. By immunohistochemical analysis, the immunocomplexes were found limitedly in the inner and outer plexiform layers of monkey retina. Conclusion:In this study, we showed high titer of autoantibodies against inner and outer plexiform layers of retina that is in the serum of the patient similar to cancer-associated retinopathy. This case is likely to be an autoimmune retinopathy.
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