Heckenlively John R, Ferreyra Henry A
Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, USA.
Semin Immunopathol. 2008 Apr;30(2):127-34. doi: 10.1007/s00281-008-0114-7. Epub 2008 Apr 12.
Three main forms of autoimmune retinopathy (AIR) have been identified over the last 15 years: cancer-associated retinopathy (CAR), melanoma-associated retinopathy (MAR), and nonneoplastic autoimmune retinopathy (npAIR). In this chapter, the term AIR will be used to encompass all three disorders where there is commonality to their features. Complicating the issue is that AIR can be a secondary complication of other conditions such as retinitis pigmentosa, ocular trauma, birdshot retinopathy, acute zonal occult outer retinopathy (AZOOR), or multiple evanescent white dot syndrome (MEWDS). The many forms of AIR tend to have common clinical features despite the fact that there has been no uniform set of anti-retinal antibodies circulating in these patients. Patients tend to have a wide variance of anti-retinal antibody activity often with three to six different antibodies found on immunoblots. Patients typically present with a sudden onset of photopsia, rapid visual loss, and abnormal electroretinograms (ERGs). Most patients have a panretinal degeneration without pigment deposits.
在过去15年里,已识别出自身免疫性视网膜病变(AIR)的三种主要形式:癌症相关性视网膜病变(CAR)、黑色素瘤相关性视网膜病变(MAR)和非肿瘤性自身免疫性视网膜病变(npAIR)。在本章中,术语AIR将用于涵盖所有这三种具有共同特征的病症。使问题复杂化的是,AIR可能是其他病症的继发性并发症,如色素性视网膜炎、眼外伤、鸟枪弹样视网膜脉络膜病变、急性区域性隐匿性外层视网膜病变(AZOOR)或多发性一过性白点综合征(MEWDS)。尽管这些患者中没有统一的一组抗视网膜抗体循环,但多种形式的AIR往往具有共同的临床特征。患者的抗视网膜抗体活性差异很大,免疫印迹通常会发现三到六种不同的抗体。患者通常表现为突然出现闪光感、快速视力丧失和异常视网膜电图(ERG)。大多数患者有全视网膜变性但无色素沉着。