Abstract
Purpose:
The autoimmune retinopathy (AIRs) is characterized by progressive vision loss, an abnormal Electroretinogram (ERG) and circulating antibodies directed against retina proteins. This study aimed to investigate the results of treatment of AIR patients with immunosuppressive therapy.
Methods:
This is a retrospective study of AIR patients who were treated with systemic immunosuppressants. Treatment outcomes were assessed by the following parameters: visual acuity (VA), mean deviation (MD) and pattern standard deviation (PSD) parameters in Humphrey visual field (HVF), implicit time and amplitude parameters in Ganzfield Electroretinograpy (ERG) and serologic findings for anti-retina and anti-optic nerve antibodies
Results:
The study included 15 eyes of 8 participants with a mean age at entry of 52.9 (± 14.0) years. Four study participants (63%) were female. The mean follow up time was 2.3 years (± 1.2 years).<br /> During the course of treatment, of all participants, one (13%) had worsening in serology findings for both anti-retina and anti-optic nerve antibodies, four (50%) improved (reduction or became negative), and two (25%) completely resolved.<br /> Of seven participants with ERG measurements, four (57%) improved in one or both eyes. Of seven participants with HVF MD measurements, five (71%) reported stable or improved MD in one or both eyes. Of all participants, five (63%) reported stable or improved VA in one or both eyes. Three study participants (37.5%) improved by 3 or 4 parameters, three (37.5%) were stable or improved by 2 parameters only, and two (25%) worsened by all parameters.<br /> Of those improved by 3-4 parameters, two participants were treated with a combination of Rituxan with Prednisone and either Cyclosporine or Cyclophosphamide, and one participant was treated with a combination of Rituxan and Cyclophosphamide. Of those stable or improved by 2 parameters only, two participants were treated with Rituxan only and one participant with combination of Rituxan and Velcade. <br />
Conclusions:
This study reported that the majority (n=6; 77%) of the patients with AIR treated with immunosuppressants were stable or improved by two or more parameters. Further studies with larger sample size and longer follow up are needed to investigate long term results of the treatment of AIR patients with immunosuppressive therapy.