A Case of Nonparaneoplastic Autoimmune Retinopathy.

Eo, Doo Ri; Yun, Ji Hyun; Kim, Sang Jin

doi:2015.56.7.1134

J Korean Ophthalmol Soc > Volume 56(7); 2015 > Article

Case Report

Journal of the Korean Ophthalmological Society 2015;56(7):1134-1140.
DOI: https://doi.org/10.3341/jkos.2015.56.7.1134 Published online July 15, 2015.

A Case of Nonparaneoplastic Autoimmune Retinopathy.

Doo Ri Eo, Ji Hyun Yun, Sang Jin Kim

¹Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sangjinkim@skku.edu
²Samsung Biomedical Research Institute, Seoul, Korea.

비부종양 자가면역망막병증 1예

어두리¹⋅윤지현²⋅김상진^1,2

성균관대학교 의과대학 삼성서울병원 안과학교실¹, 삼성생명과학연구소²

Received: 24 October 2014 • Revised: 17 March 2015 • Accepted: 4 June 2015

Abstract

PURPOSE
To report a case of nonparaneoplastic autoimmune retinopathy diagnosed using serum anti-retinal autoantibodies. CASE SUMMARY: A 60-year-old female complained of progressive visual loss in both eyes over 3 months. Her best corrected visual acuity was hand motion in the right eye, 0.9 (decimal) in the left eye, and no definite abnormal findings were identified on fundus examinations. Automated visual field test revealed severely depressed visual fields in both eyes. Standard full-field electroretinogram (ERG) revealed nearly extinguished scotopic b-waves and spectral-domain optical coherence tomography (SD-OCT) showed subtle obscuration and interruption of the inner segment/outer segment (IS/OS) junction of the photoreceptors. Using Western blotting with human retinal proteins and the patient's serum, we diagnosed nonparaneoplastic autoimmune retinopathy and performed posterior subtenon steroid injection in the right eye, systemic corticosteroids, and oral mycophenolate mofetil. Full-field ERG after treatment showed slightly increased amplitude but there was no subjective visual improvement. OCT after treatment did not reveal significant changes in the photoreceptor layer. CONCLUSIONS: This is the first reported case of nonparaneoplastic autoimmune retinopathy in Korea diagnosed using Western blotting with anti-retinal autoantibodies. Autoimmune retinopathy should be considered in patients with visual field and ERG impairment without definite fundus abnormalities.

Key Words: Anti-retinal autoantibody;Nonparaneoplastic autoimmune retinopathy;Western blot