Hyperautofluorescent ring in autoimmune retinopathy.
OBJECTIVE
To report the presence of a hyperautofluorescent ring and corresponding spectral-domain optical coherence tomography (SD-OCT) features seen in patients with autoimmune retinopathy.


METHODS
All eyes were evaluated by funduscopic examination, full-field electroretinography, fundus autofluorescence, and SD-OCT. Further confirmation of the diagnosis was obtained with immunoblot and immunohistochemistry testing of the patient's serum. Humphrey visual fields and microperimetry were also performed.


RESULTS
Funduscopic examination showed atrophic retinal pigment epithelium (RPE) associated with retinal artery narrowing but without pigment deposits. The scotopic and photopic full-field electroretinograms were nondetectable in three patients and showed a cone-rod pattern of dysfunction in one patient. Fundus autofluorescence revealed a hyperautofluorescent ring in the parafoveal region, and the corresponding SD-OCT demonstrated loss of the photoreceptor inner segment-outer segment junction with thinning of the outer nuclear layer from the region of the hyperautofluorescent ring toward the retinal periphery. The retinal layers were generally intact within the hyperautofluorescent ring, although the inner segment-outer segment junction was disrupted, and the outer nuclear layer and photoreceptor outer segment layer were thinned.


CONCLUSIONS
This case series revealed the structure of the hyperautofluorescent ring in autoimmune retinopathy using SD-OCT. Fundus autofluorescence and SD-OCT may aid in the diagnosis of autoimmune retinopathy and may serve as a tool to monitor its progression.
Vitreous, Retina, Macula Consultants of New York and The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA.
Luiz H
LH
Lima
Jonathan P
JP
Greenberg
Vivienne C
VC
Greenstein
R Theodore
RT
Smith
Juliana M F
JM
Sallum
Charles
C
Thirkill
Lawrence A
LA
Yannuzzi
Stephen H
SH
Tsang
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D059545:Paraneoplastic Syndromes, Ocular / Q000175:diagnosis* / Q000503:physiopathology; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology; D012160:Retina / Q000276:immunology; D012161:Retinal Artery / Q000473:pathology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012607:Scotoma / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields
D001323:Autoantibodies; D001324:Autoantigens