title: Autoimmune retinopathy.
abstract: OBJECTIVE
  To provide a detailed review of current clinical guidelines for the diagnosis, work-up and treatment of autoimmune retinopathy and to preview briefly possible future therapies.
  
  
  METHODS
  Perspective based on literature review and clinical expertise.
  
  
  METHODS
  Interpretation of current literature, relying on the authors' clinical experience.
  
  
  RESULTS
  Autoimmune retinopathy is a rare immunologic disease characterized by the presence of circulating antiretinal antibodies along with electroretinographic and visual field abnormalities. An ophthalmic examination can be normal or show minimal findings. The diagnosis of autoimmune retinopathy is made difficult by diagnostic criteria that are both limited and nonstandardized. Currently, the diagnosis is made based on the demonstration of serum antiretinal antibodies and the presence of clinical manifestations (including abnormal electroretinographic findings). The mere presence of these antibodies is not diagnostic. Lack of an accepted gold standard for antiretinal antibodies detection and poor interlaboratory concordance make the diagnosis challenging. There are anecdotal reports of immunosuppressive therapy in autoimmune retinopathy; however, the response to treatment is variable, with more favorable results achieved in paraneoplastic retinopathy, particularly cancer-associated retinopathy, with a combination of chemotherapy and immunosuppression. Whether an earlier attempt to treat nonparaneoplastic autoimmune retinopathy would be more beneficial is unknown. Early treatment attempts are limited by lack of sensitive and specific assays and definitive clinical criteria.
  
  
  CONCLUSIONS
  Little is known about the clinical course, prognosis and treatment of autoimmune retinopathy. Additional studies should examine the specificity and pathogenicity of antiretinal antibodies and screen for biomarkers, and they should be conducted concurrently with studies seeking to identify appropriate treatment.
authors: National Eye Institute, National Institutes of Health, Bethesda, MD.
authors: Landon
authors: L
authors: Grange
authors: National Eye Institute, National Institutes of Health, Bethesda, MD.
authors: Monica
authors: M
authors: Dalal
authors: National Eye Institute, National Institutes of Health, Bethesda, MD.
authors: Robert B
authors: RB
authors: Nussenblatt
authors: National Eye Institute, National Institutes of Health, Bethesda, MD. Electronic address: senh@nei.nih.gov.
authors: H Nida
authors: HN
authors: Sen
mesh_terms: D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D059545:Paraneoplastic Syndromes, Ocular / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D017410:Practice Guidelines as Topic; D012160:Retina / Q000276:immunology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy
chemical_list: D001323:Autoantibodies; D001324:Autoantigens