Purchase this article with an account.
Lucy Xu, Jessica Gowramma Shantha, Steven Yeh, Jiong Yan, G Baker Hubbard, Purnima Patel, Nieraj Jain, Ghazala O'Keefe; Characteristics and Outcomes of Patients with Non-Paraneoplastic Autoimmune Retinopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2097.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe the clinical characteristics and visual outcomes of patients with non-paraneoplastic autoimmune retinopathy (npAIR) at a tertiary care center.
This is a retrospective study of patients with npAIR evaluated at the Emory Eye Center between 2013-2019. Baseline and final best corrected visual acuity (BCVA), length of follow up, results of antiretinal antibody testing and therapeutic interventions were recorded. All available fundus imaging, electrophysiology, and perimetry were reviewed. BCVA was converted to logMAR values for analyses. Visual acuities of count fingers and hand motion were converted to logMAR values of 2.0 and 3.0, respectively. Eyes that were light perception and no light perception were excluded from statistical analysis. JMP Statistical Software (SAS Institute Inc, Cary, NC) was used for statistical analysis with p < 0.05 deemed as significant.
Fourteen patients (9 women, 5 men) diagnosed with npAIR were included. The median age at presentation was 59 years (range 24-85) and the median duration of symptoms prior to presentation was 2 years (range 1 month - 40 years). Median follow up duration was 15 months (range 0-67 months). Mean LogMAR BCVA was 0.348 (Snellen equivalent 20/40) at the baseline visit and 0.446 (Snellen equivalent 20/60) at the final visit (22 eyes, p=0.09). The mean deviation on Humphrey visual field testing decreased (-16.22 vs. -19.71, 9 eyes) and approached but did not reach statistical significance (p=0.053). Antiretinal antibody testing was performed on 10 patients, 2 of which were cancer related autoimmune retinopathy panels only. Three patients had no detectable antiretinal antibodies but otherwise met clinical criteria for a diagnosis of npAIR. Seven patients (50%) received one or more immunosuppressive therapy including rituximab (n=2), methotrexate (n=2), mycophenolate mofetil (n=2), prednisone (n=2) and periocular steroid injection (n=1). There was no statistical difference in the change in visual acuity between treated vs. non-treated patients (22 eyes, p=0.4).
In our series of patients with npAIR, visual acuity did not change significantly between initial visit and final visit. Three patients who met clinical diagnostic criteria for npAIR had no detectable antiretinal antibodies. Of note, follow-up intervals were variable and measures of visual function were not standardized in this retrospective study.
This is a 2020 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only