Singapore National Eye Centre, Singapore, Singapore.
Singapore Eye Research Institute, Singapore, Singapore.
Eye (Lond). 2021 Aug;35(8):2254-2259. doi: 10.1038/s41433-020-01241-y. Epub 2020 Oct 28.
The aim of this study is to evaluate the frequency and types of anti-retinal autoantibodies (ARAs) in highly myopic patients and to explore any association between ARAs and the severity of myopic macular degeneration (MMD).
This was a clinic-based study of 16 patients with high myopia (spherical equivalent worse than -6 dioptres or axial length (AL) ≥ 26.5 mm) recruited from the High Myopia clinic of the Singapore National Eye Centre. MMD was graded from fundus photographs according to the Meta-analysis for Pathologic Myopia (META-PM) classification. Severe MMD was defined as META-PM category 3 or 4. AL and logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) were measured. Sera were obtained from subjects and analysed for the presence of ARAs with the western blot technique.
The mean AL was significantly longer in patients with severe MMD (n = 8) than those without severe MMD (n = 8) (31.50 vs. 28.51, p = 0.005). There was at least one ARA identified in all patients. The most common ARA was anti-carbonic anhydrase II (anti-CAII), present in nine patients (56.3%). Anti-CAII was detected in more patients with severe MMD than those without (75 vs. 37.5%, p = 0.32). LogMar BCVA was also worse in subjects with anti-CAII (0.5 ± 0.38 vs. 0.22 ± 0.08, p = 0.06). The number of ARAs significantly correlated with increasing AL (r = 0.61, p = 0.012).
ARAs are prevalent in patients with high myopia, and this increases with increasing AL. In particular, anti-CAII antibodies were highly prevalent in patients with severe MMD, suggesting that ARAs may be associated with MMD. Further studies are necessary to confirm these observations in larger cohorts.
本研究旨在评估高度近视患者抗视网膜自身抗体（ARAs）的频率和类型，并探讨 ARAs 与近视性黄斑变性（MMD）严重程度之间的关系。
这是一项基于临床的研究，共纳入了 16 名来自新加坡国家眼科中心高度近视诊所的高度近视患者（等效球镜度>-6 屈光度或眼轴长度（AL）≥26.5mm）。根据病理性近视 Meta 分析（META-PM）分类，通过眼底照片对 MMD 进行分级。严重 MMD 定义为 META-PM 类别 3 或 4。测量 AL 和最小分辨角对数（logMAR）最佳矫正视力（BCVA）。从受试者中获取血清，并用 Western blot 技术分析 ARAs 的存在情况。
严重 MMD 组（n=8）的平均 AL 明显长于非严重 MMD 组（n=8）（31.50 比 28.51，p=0.005）。所有患者均至少有一种 ARA。最常见的 ARA 是抗碳酸酐酶 II（anti-CAII），存在于 9 名患者（56.3%）中。严重 MMD 患者中检测到抗-CAII 的比例高于无严重 MMD 患者（75%比 37.5%，p=0.32）。抗-CAII 患者的 logMAR BCVA 也较差（0.5±0.38 比 0.22±0.08，p=0.06）。ARAs 的数量与 AL 的增加显著相关（r=0.61，p=0.012）。
ARAs 在高度近视患者中普遍存在，且随着 AL 的增加而增加。特别是，严重 MMD 患者中抗-CAII 抗体高度流行，提示 ARAs 可能与 MMD 有关。需要进一步的研究来在更大的队列中证实这些观察结果。
