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Impact of anti-optic nerve antibodies in patients with autoimmune retinopathy
Prapatsorn Ongpalakorn, MD
Ongpalakorn, Prapatsorn ; Park, SungWho ; Or, Chris ;Akhavanrezayat, Amir ; Karaca, Irmak ; Bromeo, Albert John ; Mobasserian, Azadeh ; Yasar, Cigdem ; Yavari,Negin ; Uludag, Gunay ; Than, Ngoc ; Shin, YongUn ; Tran, Anh N. ; Bazojoo, Vahid ; Do, Diana V. ; Nguyen,Quan D.
1. Byers Eye Institute, Stanford University, Stanford, CA, United States.
2. Ophthalmology Department, Nopparat Rajathanee Hospital, Bangkok, Thailand.
Purpose: Given the challenging diagnosis of autoimmune retinopathy (AIR), blood tests serve as beneficial diagnostic value. In this retrospective observational case series, we investigated the correlation between the presence of anti-optic nerve antibodies (AOA) and clinical findings in patients with AIR.
Methods: Medical records of patients who were diagnosed with AIR [based on the presence of antiretinalantibodies (ARA)] from January 2017 to October 2022 were retrospectively reviewed. All patients also underwent testing for AOA. The patients were then further analyzed in two groups (positive AOA and negativeAOA). Visual acuity, optic disc leakage in fluorescein angiography (FA), and visual evoked potential (VEP)were compared between the two groups.
Results: A total of 25 patients (50 eyes) were included, of which 76% (19 patients, 38 eyes) were positive for AOA. There was no statistically significant difference between the patients with positive and negative AOA interms of age [51.22±22.79 (range, 7.7-86.9) vs. 36.85±20.43 (range, 9.3-66.7), p=0.238)], visual acuity(LogMAR 0.65±0.75 vs LogMAR 0.33±0.63, p=0.129), and baseline VEP P100 [60 min 125.60 ±15.30 (range,103.00-153.00 ms); 15 min 128.60±15.50 (range, 101.50-151.50 ms) vs. 60 min 131.41±27.99 (range, 109.50-194.00 ms); 15 min 124.30±15.73 (range, 106.00-158.50 ms), p=0.928 and 0.347, respectively]. Optic discswelling was not detected in any subject. Two of the 38 eyes (5.26%) in the positive AOA group had optic discleakage in FA, compared to two of the 12 eyes (16.67%) in the negative AOA group (p=0.240).
Conclusions: The majority of patients with AIR had positive AOA. There was no significant difference in terms of baseline clinical findings and function of the optic nerve of AIR patients with positive or negative AOA. However, longitudinal impact of the presence of AOA needs to be assessed.