Abstract
Purpose :
Autoimmune retinopathies (AIR) are a group of diseases characterized by vision loss in patients with abnormal electroretinography and antiretinal autoantibodies. Significant heterogeneity exists within patient presentations and clinical findings. Immunohistochemistry studies suggest that a subset of antiretinal autoantibodies bind to different retinal layers and may subsequently confer pathogenicity. This study examines the possible relationship between different antiretinal autoantibodies and substrata changes on spectral-domain optical coherence tomography (SD-OCT).
Methods :
A retrospective chart review of patients evaluating for AIR was performed between 2007 and 2017. Patients with AIR were identified based upon a charted diagnosis by a retina specialist, which included the presence of serum antiretinal autoantibodies confirmed by Western blot analysis. SD-OCTs were analyzed with the Iowa Reference Algorithm to measure retinal substrata thicknesses with manual correction performed as needed to ensure appropriate segmentation. Hierarchical clustering was performed on 10 segmented retinal layer thicknesses across samples. The resulting tree was split into two main clusters based on the first branch point in the tree. Statistical association between these two clusters and autoantibody positivity were assessed by Fisher exact test.
Results :
Forty-six patients (27 women) with a diagnosis of AIR received SD-OCT imaging during the study period. Fourteen patients had a history of a malignancy at the time of AIR diagnosis. Hierarchical clustering and statistical analysis did not demonstrate a significant relationship between individual retinal layer thickness and different antiretinal autoantibodies.
Conclusions :
AIR is a heterogenous group of diseases in which total retinal thinning has previously been described. The binding of a subset of antiretinal autoantibodies takes place within specific retinal layers lending credence to the idea that pathogenic changes take place at the location of antibody binding. Although different autoantibodies have been shown to preferentialy stain different retina layers on histologic studies, our results do not demonstrate a relationship between specific antiretinal autoantibodies and retinal sublayer thicknesses on SD-OCT.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.