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Non-Paraneoplastic Autoimmune Retinopathy: The First Case Report in Korea

Authors
 Eun Young Choi  ;  Min Kim  ;  Grazyna Adamus  ;  Hyoung Jun Koh  ;  Sung Chul Lee 
Citation
 Yonsei Medical Journal, Vol.57(2) : 527-531, 2016 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2016
MeSH
Autoantibodies/blood* ; Autoantibodies/immunology ; Autoantigens ; Autoimmune Diseases/immunology* ; Electroretinography ; Humans ; Immunologic Factors ; Paraneoplastic Syndromes/immunology* ; Paraneoplastic Syndromes, Ocular ; Phosphopyruvate Hydratase ; Recoverin ; Republic of Korea ; Retina/immunology* ; Retinal Diseases/immunology* ; Tomography, Optical Coherence
Keywords
AIR ; Autoimmune retinopathy ; antiretinal antibodies ; enolase ; nonparaneoplastic autoimmune retinopathy ; recoverin
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.
Files in This Item:
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DOI
10.3349/ymj.2016.57.2.527
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Kim, Da Hee(김다희) ORCID logo https://orcid.org/0000-0001-7286-1334
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Lee, Sung Chul(이성철) ORCID logo https://orcid.org/0000-0001-9438-2385
Choi, Eun Young(최은영) ORCID logo https://orcid.org/0000-0002-1668-6452
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146606
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