Plasma Antiretinal Autoantibody Profiling and Diagnostic Efficacy in Patients With Autoimmune Retinopathy

초록

center dot PURPOSE: To evaluate plasma antiretinal autoantibody (ARA) profiling and diagnostic efficacy for autoimmune retinopathy (AIR).center dot DESIGN: A multicenter, diagnostic evaluation study.center dot METHODS: Forty-nine patients with a clinical diagno-sis of AIR, disease controls including 20 patients with retinitis pigmentosa (RP), and 30 normal controls were included. Plasma samples from patients were analyzed for the presence of 6 ARAs, including recoverin, a-enolase, carbonic anhydrase II, heat shock protein 60, aldolase C, and cone-rod homeobox/cone-rod retinal dystrophy 2 us-ing western blotting.center dot RESULTS: Autoantibody detection rates against cone -rod homeobox/cone-rod retinal dystrophy 2, heat shock protein 60, and aldolase C in AIR were 67.3%, 40.8%, and 42.9%, respectively, which were higher than those in RP and normal controls ( P < .001, P < .001, and P = .007, respectively), but recoverin, a-enolase, and carbonic anhydrase II were not different from other con-trol groups ( P = .117, P = .774, and P = .467, re-spectively). Among ARAs, antirecoverin antibody was the most specific, as it was found in 3 (6.1%) patients with AIR and none of the control groups. As the number of detected ARAs increased, the probability of AIR in -creased (odds ratio: 1.913; P < .001; 95% confidence in-terval: 1.456-2.785). The positive number of ARAs was significantly higher when photoreceptor disruption was observed on optical coherence tomography, or severe dys-function was observed in electroretinography ( P = .022 and P = .029, respectively).center dot CONCLUSIONS: The profiles of ARAs in the AIR group were different from those in the RP and normal controls. The higher number of positive ARAs suggests a higher possibility of AIR diagnosis. ARAs should be used as ad-junct tools for the clinical diagnosis of AIR. (Am J Ophthalmol 2023;245: 145-154. (c) 2022 Elsevier Inc. All rights reserved.)

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