Autoimmune retinopathy(AIR)refers to both paraneoplastic and non-paraneoplastic forms of a rare,acquired retinal degeneration thought to be mediated by the production of antiretinal antibodies.However,the mechanisms u...Autoimmune retinopathy(AIR)refers to both paraneoplastic and non-paraneoplastic forms of a rare,acquired retinal degeneration thought to be mediated by the production of antiretinal antibodies.However,the mechanisms underlying AIR pathogenesis are incompletely understood,and it remains a diagnosis of exclusion given the lack of definitive testing as well as its protean clinical presentation.This review summarizes the current literature on the epidemiology,diagnosis,and management of AIR,with a focus on non-paraneoplastic disease and the potential role of immunomodulatory therapy.A recent expert consensus statement on diagnosis and management of non-paraneoplastic AIR served as a framework for interpreting the limited data available,a process that was complicated by the small sample sizes,heterogeneity,and retrospective nature of these studies.Additional work is needed to characterize AIR patients on the basis of cytokine and immunogenetic profiling;to establish the pathogenicity of antiretinal antibodies;and to standardize treatment regimens as well as assessment of clinical outcomes.展开更多
Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degen...Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degeneration of photoreceptors. But the precise mechanism has not been fully established, CAR may result from autoimmune mediated apoptosis. And in recent years, there also have been some results demonstrating that tumor derived angiogenic factors such as VEGF may also confer the development of CAR, which may offer novel avenues for the therapeutic intervention in CAR. Early initiation of immunosuppressive therapy is critical for vision preservation. Future developments in rapid identification and longitudinal quantification of antibody levels would enable individualized management in these patients. The goal of this review was to analyze the epidemiology, the clinical features, the diagnosis and management of retinopathy in the context of recent advances in the elucidation of breast cancer-associated retinopathy (BCAR) pathogenesis.展开更多
文摘Autoimmune retinopathy(AIR)refers to both paraneoplastic and non-paraneoplastic forms of a rare,acquired retinal degeneration thought to be mediated by the production of antiretinal antibodies.However,the mechanisms underlying AIR pathogenesis are incompletely understood,and it remains a diagnosis of exclusion given the lack of definitive testing as well as its protean clinical presentation.This review summarizes the current literature on the epidemiology,diagnosis,and management of AIR,with a focus on non-paraneoplastic disease and the potential role of immunomodulatory therapy.A recent expert consensus statement on diagnosis and management of non-paraneoplastic AIR served as a framework for interpreting the limited data available,a process that was complicated by the small sample sizes,heterogeneity,and retrospective nature of these studies.Additional work is needed to characterize AIR patients on the basis of cytokine and immunogenetic profiling;to establish the pathogenicity of antiretinal antibodies;and to standardize treatment regimens as well as assessment of clinical outcomes.
文摘Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degeneration of photoreceptors. But the precise mechanism has not been fully established, CAR may result from autoimmune mediated apoptosis. And in recent years, there also have been some results demonstrating that tumor derived angiogenic factors such as VEGF may also confer the development of CAR, which may offer novel avenues for the therapeutic intervention in CAR. Early initiation of immunosuppressive therapy is critical for vision preservation. Future developments in rapid identification and longitudinal quantification of antibody levels would enable individualized management in these patients. The goal of this review was to analyze the epidemiology, the clinical features, the diagnosis and management of retinopathy in the context of recent advances in the elucidation of breast cancer-associated retinopathy (BCAR) pathogenesis.
