Kurz Paul A, Reem Rachel E, Kurz Daryl E, Weleber Richard G
Dayton VA Medical Center, Dayton, OH 45428, USA.
Case Rep Ophthalmol Med. 2011;2011:371324. doi: 10.1155/2011/371324. Epub 2011 Dec 19.
Background. We report a case of autoimmune retinopathy associated with anti-alpha-enolase antibodies with unique manifestations. Methods. A case report. Results. A 30-year-old male experienced recurrent, primarily peripheral visual field disturbances and minimal photopsia, with interval symptom resolution. Fundus changes subsequently developed in areas corresponding to the previous visual field symptoms. Electroretinogram showed bilaterally symmetric abnormalities of light-adapted responses and suggested loss of photoreceptor function. Only anti-alpha-enolase antibodies were detected on Western blot. Our patient noted cutaneous symptoms at the time of both episodes of visual symptoms, but not in the interim. Biomicroscopy revealed subtle small reddish spots in areas of the peripheral retina corresponding to the areas of the patient's visual field where he noted symptoms. To our knowledge these reddish spots have not been reported in autoimmune retinopathy and may clinically support in vitro and in vivo evidence that anti-alpha-enolase antibodies may target photoreceptors. Conclusions. Our patient demonstrates some unique features adding to the known characteristics of autoimmune retinopathy associated with anti-alpha-enolase antibodies. As more cases are reported, further understanding of the features and pathophysiology of this rare condition will hopefully be elucidated.
背景。我们报告一例与抗α-烯醇化酶抗体相关的自身免疫性视网膜病变，具有独特表现。方法。病例报告。结果。一名30岁男性反复出现主要为周边视野障碍和轻微的闪光感，症状有间歇性缓解。随后在与先前视野症状相对应的区域出现眼底改变。视网膜电图显示双侧对称的明适应反应异常，提示光感受器功能丧失。免疫印迹法仅检测到抗α-烯醇化酶抗体。我们的患者在两次视觉症状发作时均出现皮肤症状，但在发作间期未出现。生物显微镜检查发现在周边视网膜与患者自述有症状的视野区域相对应的部位有细微的小红斑。据我们所知，这些红斑在自身免疫性视网膜病变中尚未见报道，可能在临床上支持抗α-烯醇化酶抗体可能靶向光感受器的体外和体内证据。结论。我们的患者表现出一些独特特征，丰富了与抗α-烯醇化酶抗体相关的自身免疫性视网膜病变的已知特征。随着更多病例的报道，有望进一步阐明这种罕见疾病的特征和病理生理学。
