Bhavsar Kavita V, Hedges Thomas, Thirkill Charles E, Reichel Elias
Ophthalmic Surg Lasers Imaging Retina. 2015 Mar;46(3):373-6. doi: 10.3928/23258160-20150323-13.
The authors describe two rare cases of autoimmune retinopathy associated with follicular cell lymphoma, including a 54-year-old man who experienced nyctalopia for 1 year (patient 1) and a 59-year-old man who had bilateral loss of central vision for 6 months (patient 2). Visual field testing of patient 1 revealed nonspecific defects, and multifocal electroretinogram (ERG) testing showed mildly subnormal amplitudes more pronounced in the left than the right eye. Serologic testing detected antibodies against a 47-kD protein, presumed to be alpha-enolase. Goldmann perimetry of patient 2 showed dense central scotomas, and a full-field ERG revealed reduced amplitudes of bright scotopic responses. Serological testing yielded anti-bipolar cell antibodies. A variable presentation of autoimmune retinopathy can occur in the setting of follicular cell lymphoma. Disparate serum autoantibodies may have mediated the pathogenesis of retinal degeneration in these two patients and could explain the difference in course and severity of retinopathy.
作者描述了两例与滤泡性细胞淋巴瘤相关的罕见自身免疫性视网膜病变病例，其中一例为一名54岁男性，有1年夜盲症病史（患者1），另一例为一名59岁男性，双侧中心视力丧失6个月（患者2）。患者1的视野测试显示非特异性缺损，多焦视网膜电图（ERG）测试显示轻度低于正常幅度，左眼比右眼更明显。血清学检测发现针对一种47-kD蛋白的抗体，推测为α-烯醇化酶。患者2的Goldmann视野检查显示致密的中心暗点，全视野ERG显示明亮暗视反应幅度降低。血清学检测产生抗双极细胞抗体。在滤泡性细胞淋巴瘤的情况下，自身免疫性视网膜病变可能会有不同的表现。不同的血清自身抗体可能介导了这两名患者视网膜变性的发病机制，并可以解释视网膜病变病程和严重程度的差异。
