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Weilin Chan, Lynn Stanwyck, Arjun sood, John Romano, Maria Pefkianaki, Thiran Jayasundera, John R Heckenlively, Steven K Lundy, Lucia Sobrin; Correlation of immunohistochemical markers with disease and clinical outcome measures in patients with autoimmune retinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6676. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if common immunological markers are significantly different between autoimmune retinopathy (AIR) patients and normal controls and correlate with disease progression in AIR patients.
We enrolled AIR patients seen at the Massachusetts Eye and Ear from February 2016 to February 2018. Normal controls were enrolled from the University of Michigan and had no history of eye disease, autoimmune disease, or cancer. For each participant, a blood sample was tested for immunological markers at the University of Michigan. For AIR patients, blood samples were collected every 6 months. Clinical measurements were recorded at each draw including visual acuity (VA), electroretinogram (ERG) parameters, and Goldmann visual field (GVF) area. Patients were treated with a variety of therapies including antimetabolites and rituximab. We used the Mann Whitney U Test to compare markers between AIR patients and normal controls. We used multilevel mixed-effect linear regression to investigate the correlation between immunological markers and clinical parameters over time in AIR patients. All statistical analyses were done in STATA 12.1.
Seventeeen AIR patients, 4 men and 13 women, with a median age of 56 years were enrolled. Fourteen normal controls were enrolled. In the primary analysis which compared normal controls to AIR patients, the percent of monocytes was significantly higher in AIR patients compared to healthy controls (Z = 3.076, P = 0.0021). An increase in IgG against recoverin was significantly correlated with worsening visual acuity as measured on the logMAR scale (β = 0.438, P < 0.0001). An increase in the proportion of monocytes was significantly correlated with a decline in the GVF I4e isopter area (β = -72.74, P = 0.0021). In addition, markers of B cell depletion (decreased percentage of CD19+ B cells, increased percentage of CD43+CD27+ B-1 cells, and decreased percentage of CD24hiCD27+ B memory cells) were significantly correlated with improvement in GVF I4e and V4e isopter areas.
Monocytes may play a role in AIR pathophysiology and be a marker for disease activity. Markers of B cell depletion correlate with improvement in clinical parameters in AIR, particularly GVF, providing additional evidence that B cell depletion with rituximab can be an effective treatment for this.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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