Retinopathies associated with antiretinal antibodies

The pathogenetic involvement of antibodies or cellular immunity to retinal proteins in humans is not clear. In this brief review, we have presented evidence that selected retinopathies are associated with the development of antiretinal antibodies. The initiating factors that contribute to the generation of these autoantibodies may vary with the different clinicopathological settings. In CAR, antibodies are directed against tumor-induced antigens that also recognize proteins within the retina. In infection-associated retinopathies, antibodies directed against an infectious agent may cross-react with retinal proteins or the antibodies react with retinal antigens released during the infection. In the retinal degenerative diseases, antibodies have been identified that react to a variety of retinal antigens. In these diseases it is difficult to determine if the antiretinal antibodies initiated the disease process or if the retinal degeneration occurred first and an immune response was later triggered against selected released retinal antigens. Irrespective of the initiating event, the presence of antiretinal antibodies may contribute to the pathologic processes involved in selected retinopathies. Presently, the identification of antiretinal antibodies is neither specific nor sensitive for the diagnosis of retinopathies. Nevertheless, demonstration of these antibodies may be helpful as diagnostic and prognostic markers in patients with retinal diseases. Analysis of immune-mediated vision loss is in its infancy, and a careful analysis and characterization of antiretinal antibody specificies will help in our understanding of the mechanisms and the diagnosis of patients with this form of vision loss.