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Management of autoimmune retinopathies with immunosuppression Ferreyra HA; Jayasundera T; Khan NW; He S; Lu Y; Heckenlively JRArch Ophthalmol 2009[Apr]; 127 (4): 390-7OBJECTIVE: To report the results of treating autoimmune retinopathy (AIR) with immunosuppression therapy. METHODS: Retrospective review of 30 consecutive patients with AIR followed for 3 to 89 months (median, 17 months) who were treated with immunosuppression (systemic or local). Subgroups were cancer-associated retinopathy (CAR), nonparaneoplastic AIR (npAIR), and npAIR with cystoid macular edema (npAIR/CME). Outcome measures were improvement of Snellen visual acuity by at least 2 lines, expansion of the visual field area by more than 25%, and resolution of CME. RESULTS: Overall, 21 of 30 patients (70%) showed improvement. All 6 CAR patients, 7 of 13 (54%) with npAIR, and 8 of 11 (73%) with npAIR/CME showed improvement. Five of 21 patients (24%) had improvement in visual acuity, 15 of 21 (71%) had expansion of visual field area, and 6 of 11 (55%) had resolution of CME. Twenty-six of 30 patients exhibited diffuse retinal atrophy without pigment deposits. An autoimmune family history was common in all the groups: npAIR, 69% (9 of 13); npAIR/CME, 64% (7 of 11); and CAR, 50% (3 of 6). CONCLUSIONS: Long-term treatment with immunosuppression resulted in clinical improvement in all subgroups of AIR. The most responsive subgroup was CAR; the least was npAIR. These results challenge the commonly held belief that AIR is untreatable.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Autoantibodies/blood[MESH]|Autoantigens/immunology[MESH]|Autoimmune Diseases/*drug therapy/immunology[MESH]|Azathioprine/*therapeutic use[MESH]|Blotting, Western[MESH]|Child[MESH]|Cyclosporine/*therapeutic use[MESH]|Drug Therapy, Combination[MESH]|Electrophoresis, Polyacrylamide Gel[MESH]|Female[MESH]|Humans[MESH]|Immunosuppressive Agents/*therapeutic use[MESH]|Macular Edema/drug therapy/immunology[MESH]|Male[MESH]|Middle Aged[MESH]|Paraneoplastic Syndromes/drug therapy/immunology[MESH]|Prednisone/*therapeutic use[MESH]|Retinal Diseases/*drug therapy/immunology[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH] |
