Abstract
Purpose :
Anti-retinal antibody (ARA) detection is part of the autoimmune retinopathy (AIR) diagnostic criteria. It is not known, however, if a decrease in ARA bands on Western blot is a reliable biomarker of treatment response. The purpose of this retrospective study was to examine the association between a decrease in ARA bands and improvement in clinical outcomes of visual acuity (VA), electroretinogram (ERG) parameters and optical coherence tomography (OCT) before and after treatment.
Methods :
This study was approved by the Massachusetts Eye and Ear (MEE) institutional review board and conformed to the provisions of the Declaration of Helsinki. We identified patients who met diagnostic criteria for AIR and had ARA Western blot testing done before and after treatment. Clinical characteristics were recorded including VA, ERG parameters, and central retinal thickness (CRT) measured by OCT before and after treatment. A significant improvement or decline in VA was defined as an increase or decrease of ≥ 2 lines, respectively. A significant improvement or worsening in ERG amplitudes was defined as an increase or decrease of ≥ 40%, respectively. We used a multilevel regression model adjusted for age and sex to investigate the association between change in ARA bands and VA, ERG parameters, and CRT. Statistical analyses were performed in STATA 12.1 (College Station, TX).
Results :
18 eyes of 9 AIR patients (mean age 58 years, 4 women) met the inclusion criteria. Regression models adjusted for age and sex did not show any association between a decrease in ARA bands and odds of improvement or stabilization of VA [Odds ratio = 1.61, 95% Confidence Interval (CI) = 0.11 to 23.81, P = 0.73] nor did they show any association between a decrease in ARA bands and odds of improvement or stabilization of ERG amplitudes (Blue 0.5 Hz: P = 0.31; White 30Hz: P = 0.68). Regression models adjusted for age, sex, and macular cystic changes also did not show an association between a decrease in ARA bands and change in CRT (β = 5.27, 95% CI = -8.49 to 19.03, P = 0.45).
Conclusions :
We did not find an association between a decrease in the number of ARA bands on Western blot and clinical outcomes after treatment. These findings, which need to be confirmed in larger studies, suggest a change in number of ARA bands is not a consistent biomarker of response to AIR treatment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.