title: Autologous antibodies to outer retina in acute zonal occult outer retinopathy.
abstract: OBJECTIVE
  Our aim was to use molecular biological methods to study evidence of autoimmune disease in five patients with acute zonal occult outer retinopathy (AZOOR).
  
  
  METHODS
  Ophthalmologic data and sera were collected from all patients, who underwent visual field (VF) examination, optical coherence tomography (OCT), and multifocal electroretinogram (mfERG) recording. Serum was prepared from each patient's blood and analyzed for antiretinal antibody activity using immunohistochemistry and Western blot analysis on mouse and human retinas. We also searched for antigen proteins using mass spectrometry.
  
  
  RESULTS
  Symptoms were blurred vision in three patients and VF defects in two; all had enlargement of the Mariotte blind spot by VF testing. OCT findings in areas corresponding to the scotoma revealed disruptions of junction borders between inner and outer segment lines. mfERGs amplitudes were reduced in each corresponding scotoma area. Immunohistochemical serum staining revealed the target antigen was present in all photoreceptors of the mouse sensory retina. Western blot analysis using patient serum samples revealed some possible candidate antigens. Mass spectrometry could not determine the causative antigen; however, a list of candidates was discovered.
  
  
  CONCLUSIONS
  We determined that AZOOR could be an autoimmune disease. All AZOOR patients tested using molecular biological methods had antiretinal antigens.
authors.affiliation: Ophthalmology Department, Kobe Kaisei Hospital, 3-11-15 Shinoharakita-Machi, Nada-Ku, Kobe, Japan, mizuki1979feb@yahoo.co.jp.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Tagami
authors.forename: Wataru
authors.initials: W
authors.lastname: Matsumiya
authors.forename: Hisanori
authors.initials: H
authors.lastname: Imai
authors.forename: Sentaro
authors.initials: S
authors.lastname: Kusuhara
authors.forename: Shigeru
authors.initials: S
authors.lastname: Honda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Azumi
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D015153:Blotting, Western; D002648:Child; D004591:Electrophoresis, Polyacrylamide Gel; D004596:Electroretinography; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D012607:Scotoma / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D053719:Tandem Mass Spectrometry; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D000080363:White Dot Syndromes; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D001324:Autoantigens