Adamus Grazyna
Ocular Immunology Laboratory, Casey Eye Institute, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States.
Invest Ophthalmol Vis Sci. 2015 Mar 9;56(3):1680-8. doi: 10.1167/iovs.14-15739.
Cancer-associated retinopathy (CAR) is an uncommon paraneoplastic disorder of the retina that is frequently associated with breast cancer in pre- and postmenopausal women older than 50 years. In this review, we will give an update on the current knowledge regarding the association of antiretinal autoantibodies with the breast-CAR syndrome. Women with breast cancer and visual indications of CAR have a significantly increased incidence of autoantibodies (AAbs) against retinal proteins when compared to healthy women. The onset of visual loss in association with antiretinal AAbs peaks 2 to 3 years after the clinical diagnosis of breast cancer. Differences in severity of symptoms between women with or without antiretinal AAbs are evident, revealing more unfavorable presentation in seropositive women. The incidence of CAR in breast cancer is likely to rise as the survival time of patients with breast cancer increases; consequently, a prediction of breast-CAR based on autoimmunity to individual retinal antigens, or to panels of antigens (signatures), is clinically important.
癌症相关性视网膜病变(CAR)是一种罕见的视网膜副肿瘤性疾病,常与50岁以上绝经前后女性的乳腺癌相关。在本综述中,我们将更新关于抗视网膜自身抗体与乳腺癌-CAR综合征关联的当前知识。与健康女性相比,患有乳腺癌且有CAR视觉指征的女性针对视网膜蛋白的自身抗体(AAbs)发生率显著增加。与抗视网膜AAbs相关的视力丧失发作在乳腺癌临床诊断后2至3年达到高峰。有或没有抗视网膜AAbs的女性在症状严重程度上存在明显差异,血清阳性女性的表现更差。随着乳腺癌患者生存时间的增加,乳腺癌中CAR的发生率可能会上升;因此,基于对个体视网膜抗原或抗原组(特征)的自身免疫来预测乳腺癌-CAR在临床上具有重要意义。