Retinopathies associated with antiretinal antibodies.

The identification of autoantibodies during the course of a disease has been shown to be useful in making a diagnosis, understanding mechanisms of pathogenesis, identifying therapeutic strategies, and monitoring treatments. Numerous examples of the utility of autoantibody detection are seen in both systemic and organ-specific diseases. The topic of immunemediated vision loss, with an emphasis on autoimmune reactivity and autoimmune disease in the eye, is a rapidly expanding area of research and therapy. The maintenance of self-tolerance within the retina may be overcome by a combination of factors, including both genetic and environmental factors. In this review we highlight retinopathies that are associated with the presence of antiretinal antibodies. We should stress that we are not inferring that all of the antiretinal antibodies described in this review are actually inducing ocular disease. Rather, we wish to highlight the concept that one may utilize sera to identify immune reactivity in the posterior segment of the eye. The detection of autoantibodies may allow one to subtype the disease according to its autoantibody profile. This process may help to define specific subgroups of retinopathies in terms of pathogenesis and therapy. When there is immune-mediated retinal damage, it may result from a combination of factors, such as antibodies, activation of T cells and macrophages, and cytokine production. In fact, cytokines, chemokines, and adhesion molecules produced by infiltrating and ocular resident cells may contribute significantly to ocular tissue damage. A variety of human and experimental retinopathies are associated with the production of antiretinal antibodies. As is shown in Table 1, these retinopathies can be categorized into three groups: (i) visual paraneoplastic disorders, frequently referred to as cancer-associated retinopathies (CAR), (ii) infection-associated retinopathies and (iii) retinal degenerative disorders.