title: Non-Paraneoplastic Autoimmune Retinopathy: The First Case Report in Korea.
abstract: Autoimmune retinopathy (AIR) is an immune-mediated retinopathy, resulting from an immunologic process caused by the aberrant recognition of retinal antigens as autoantigens. The diagnosis of AIR involves the detection of antiretinal antibodies with concurrent clinical and electrophysiological evidence of retinopathy. A 40-year-old patient presented with progressive loss of bilateral vision over several months. A fundus examination was unremarkable. Spectral domain optical coherence tomography revealed a blurred photoreceptor ellipsoid zone at the subfoveal region in both eyes with more prominent disruption in the left eye. Full-field electroretinography (ERG) showed relatively normal rod and cone responses in the right eye, and decreased photopic bwaves with minimal attenuation of a-waves in the left eye. Multifocal ERG demonstrated slightly reduced amplitude of the inner segment ring in the right eye and decreased amplitudes and delayed latencies of all modalities in the left eye. The patient was suspected to have AIR and it was supported by positive Western blots for 23-kDa protein, enolase (46-kDa), aldolase (40-kDa), 62-kDa and 78-kDa proteins and by immunohistochemical staining of human retinal bipolar and ganglion cells. Despite the immunosuppressive treatment, the destruction of the retinal photoreceptors progressed, and immunosuppressive interventions produced very little visual improvement. We report on what is, to the best of our knowledge, the very first case of serologically confirmed nonparaneoplastic AIR in Korea.
authors: Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Eun Young
authors: EY
authors: Choi
authors: Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. minkim76@hotmail.com.
authors: Min
authors: M
authors: Kim
authors: Ocular Immunology Laboratory, Casey Eye Institute-BRB, Oregon Health & Science University, Portland, OR, USA.
authors: Grazyna
authors: G
authors: Adamus
authors: The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hyoung Jun
authors: HJ
authors: Koh
authors: The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Sung Chul
authors: SC
authors: Lee
mesh_terms: D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001324:Autoantigens; D001327:Autoimmune Diseases / Q000276:immunology*; D004596:Electroretinography; D006801:Humans; D007155:Immunologic Factors; D010257:Paraneoplastic Syndromes / Q000276:immunology*; D059545:Paraneoplastic Syndromes, Ocular; D010751:Phosphopyruvate Hydratase; D051603:Recoverin; D056910:Republic of Korea; D012160:Retina / Q000276:immunology*; D012164:Retinal Diseases / Q000276:immunology*; D041623:Tomography, Optical Coherence
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D007155:Immunologic Factors; D051603:Recoverin; D010751:Phosphopyruvate Hydratase
keywords: AIR; Autoimmune retinopathy; antiretinal antibodies; enolase; nonparaneoplastic autoimmune retinopathy; recoverin