Anti-retinal autoantibodies in myopic macular degeneration: a pilot study

Abstract

Aim The aim of this study is to evaluate the frequency and types of anti-retinal autoantibodies (ARAs) in highly myopic patients and to explore any association between ARAs and the severity of myopic macular degeneration (MMD). Methods This was a clinic-based study of 16 patients with high myopia (spherical equivalent worse than −6 dioptres or axial length (AL) ≥ 26.5 mm) recruited from the High Myopia clinic of the Singapore National Eye Centre. MMD was graded from fundus photographs according to the Meta-analysis for Pathologic Myopia (META-PM) classification. Severe MMD was defined as META-PM category 3 or 4. AL and logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) were measured. Sera were obtained from subjects and analysed for the presence of ARAs with the western blot technique. Results The mean AL was significantly longer in patients with severe MMD (n = 8) than those without severe MMD (n = 8) (31.50 vs. 28.51, p = 0.005). There was at least one ARA identified in all patients. The most common ARA was anticarbonic anhydrase II (anti-CAII), present in nine patients (56.3%). Anti-CAII was detected in more patients with severe MMD than those without (75 vs. 37.5%, p = 0.32). LogMar BCVA was also worse in subjects with anti-CAII (0.5 ± 0.38 vs. 0.22 ± 0.08, p = 0.06). The number of ARAs significantly correlated with increasing AL (r = 0.61, p = 0.012). Conclusions ARAs are prevalent in patients with high myopia, and this increases with increasing AL. In particular, anti-CAII antibodies were highly prevalent in patients with severe MMD, suggesting that ARAs may be associated with MMD. Further studies are necessary to confirm these observations in larger cohorts.

Autoimmune-Related Retinopathy Presenting As Plaquenil Toxicity in Patients With Systemic Lupus Erythematosus

“…16,23 Anti-retinal AAbs vary widely, and their presence in normal humans and many retinal diseases has also been demonstrated. [24][25][26] Studies of the formation mechanisms of autoantibodies state that antigens emerging during the anti-tumor process or any infectious pathogen's antigens may be similar to retinal antigens and cause AAb production. 27,28 The eye is an immune-privileged organ with various antiinflammatory molecules, barriers, and mechanisms to suppress immune action.…”

Are There Two Forms of Multiple Evanescent White Dot Syndrome?

“…14 Other studies have also looked at retinal autoantibodies in associated conditions including myopic macular degeneration and acute zonal occult outer retinopathy. [27][28][29] The roles of such antibodies are unknown and will depend on future studies to elucidate their pathogenic contributions.…”

Autoantibody profiles and clinical association in Thai patients with autoimmune retinopathy

“…Anti-α-enolase autoantibody can penetrate the retinal tissue, reach its targets in the GCL and INL, and induce apoptotic cell death 32 . The autoantibody against CAII was also reported to induce target cell apoptosis by deranging the cells’ metabolism through the inhibition of this protein’s catalytic activities 33 , 34 . Anti-CAII is thus often associated with more severe clinical outcomes in AIR patients 34 , although we did not find significant association between anti-CAII autoantibody and the disease outcomes in this study.…”