Monitoring Autoimmune Reactivity within the Retina

The identification of immune reactivity against self components is a key element in the characterization of autoimmunity and autoimmune diseases. This autoimmune reactivity is most frequently monitored by the detection of specific autoantibodies or the presence of T cell reactivity to self-peptides. Although rare, retinal autoimmunity exists as a naturally occurring disease in humans and as an experimentally designed animal model system. Autoimmune retinopathy is an inflammation-mediated retinopathy characterized by vision loss, scotomas, visual field deficits, photoreceptor dysfunction, and the presence of circulating antiretinal antibodies. Standard immunohistochemical assays or immunofluorescent assays are used to identify antibody reactivity within the retina. In patients with antiretinal antibodies, the cellular location can be important to report and may provide clues to help distinguish the disease entity. At least five patterns of immunostaining are commonly observed in retina tissue: photoreceptor inner and outer segments, inner nuclear layer, outer nuclear layer, ganglion cells, and retinal pigment epithelium cells.