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中心性浆液性脉络膜视网膜病变中的抗视网膜抗体:患病率及临床意义

Antiretinal antibodies in central serous chorioretinopathy: prevalence and clinical implications.

作者信息

Ten Berge Josianne C E M, van Dijk Elon H C, Schreurs Marco W J, Vermeer Jacolien, Boon Camiel J F, Rothova Aniki

机构信息

Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands.

Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

Acta Ophthalmol. 2018 Feb;96(1):56-62. doi: 10.1111/aos.13445. Epub 2017 Apr 26.

Abstract

PURPOSE

To investigate the possible role of autoimmune reactions directed against retinal tissue in central serous chorioretinopathy (CSC), by analysing the presence of serum antiretinal antibodies (ARAs) and establishing their clinical relevance.

METHODS

Sixty-three patients with CSC were included, and clinical characteristics were collected. Serum samples of all patients with CSC, 101 uveitis patients and 60 healthy donors were analysed for the presence of ARAs by indirect immunofluorescence. Furthermore, all CSC serum samples were analysed on Western blot. Correlations between laboratory findings and clinical features of CSC were determined by logistic regression.

RESULTS

Antiretinal antibodies (ARAs) were present in 54% of the patients with CSC, in 46% of uveitis patients (p = 0.153) and in 17% of healthy controls (p < 0.001). The majority of ARAs in CSC were directed against photoreceptors (27%), which occurred significantly more often compared to uveitis patients (15%, p = 0.039) and to healthy controls (5%, p = 0.003). No associations between clinical CSC characteristics and the presence of ARAs were found.

CONCLUSION

Serum ARAs are present in more than half of the patients with CSC, and especially, ARAs directed against photoreceptors were detected more frequently compared to both healthy controls and uveitis patients. Further research is warranted to unravel the role of ARAs in the pathogenesis of CSC.

摘要

目的

通过分析血清抗视网膜抗体(ARA)的存在情况并确定其临床相关性,探讨针对视网膜组织的自身免疫反应在中心性浆液性脉络膜视网膜病变(CSC)中可能发挥的作用。

方法

纳入63例CSC患者,收集其临床特征。采用间接免疫荧光法分析所有CSC患者、101例葡萄膜炎患者及60例健康对照者血清样本中ARA的存在情况。此外,对所有CSC血清样本进行蛋白质印迹分析。通过逻辑回归确定CSC实验室检查结果与临床特征之间的相关性。

结果

54%的CSC患者存在抗视网膜抗体(ARA),46%的葡萄膜炎患者存在ARA(p = 0.153),17%的健康对照者存在ARA(p < 0.001)。CSC患者中大多数ARA针对光感受器(27%),与葡萄膜炎患者(15%,p = 0.039)和健康对照者(5%,p = 0.003)相比,这种情况出现的频率显著更高。未发现CSC临床特征与ARA存在之间的关联。

结论

超过半数的CSC患者血清中存在ARA,尤其是与健康对照者和葡萄膜炎患者相比,针对光感受器的ARA检测更为频繁。有必要进一步研究以阐明ARA在CSC发病机制中的作用。

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