Rapidly progressive retinopathy with a normal fundus: Immune pathology

Abstract

Abstract: : Purpose: Immune mediated visual loss is a rapidly expanding area of research in autoimmune disease of the eye. In this study our aim is to detect systemic autoantibodies to the retina in the sera of a specific subset of patients that are described to have a rapidly progressive retinopathy with a normal fundus, which has not been reported before. Patients and Methods:Patients (n=16) with this suspected rapidly progressive retinopathy were recruited from the medical retina clinic along with age matched normal controls (n=16). Clinical findings included visual acuity ranging from 6/12 – 1/60, with normal fundal findings. Autofluoresence imaging was normal however ERG findings revealed preferential cone loss. The sera of these patients was analysed with indirect immunohistochemistry and western immunoblot analysis on murine (BALB/c) retinal tissue for the presence of antiretinal autoantibodies. Results: Heterogeneous immunohistochemical staining patterns were seen with the sera of these patients as compared with controls. Majority of the affected patients (9/16) stained with an antinuclear pattern. The antiretinal antibodies from the sera of these patients partly reacted with the retinal protein of molecular weight between 28.9 to 34.8 Kd, and partly with the protein of molecular weight between 34.8 to 49.1 Kd. Conclusion: The data suggest that these antiretinal autoantibodies may be involved in the immune process of this rapidly progressive retinopathy. The presence of these autoantibodies could suggest a significant role of the immune system in the pathogenesis of this retinopathy.

Keywords: autoimmune disease • immunohistochemistry • retina