You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 127 No. 4, April 2009 TABLE OF CONTENTS
  Archives
  •  Online Features
  Clinical Sciences
 This Article
 •Full text
 •PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (1)
 •Contact me when this article is cited
 Related Content
 •Related article
 •Similar articles in this journal
 Topic Collections
 •Macular Disorders
 •Ocular/ Adnexal Tumors
 •Retinal/ Chorioretinal Disorders
 •Articles for Residents
 •Drug Therapy
 •Drug Therapy, Other
 •Immunology
 •Immunology, Other
 •Alert me on articles by topic
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Management of Autoimmune Retinopathies With Immunosuppression

Henry A. Ferreyra, MD; Thiran Jayasundera, MD; Naheed W. Khan, PhD; Shirley He, PhD; Ying Lu, PhD; John R. Heckenlively, MD

Arch Ophthalmol. 2009;127(4):390-397.

Objective  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.


Author Affiliations: Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor (Drs Ferreyra, Jayasundera, Khan, He, Lu, and Heckenlively); and Department of Ophthalmology, Shiley Eye Center, University of California, San Diego (Dr Ferreyra).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

RELATED ARTICLE

Immunosuppression for Autoimmune Retinopathy
Lee M. Jampol and Gerald A. Fishman
Arch Ophthalmol. 2009;127(4):573-575.
EXTRACT | FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Immunosuppression for Autoimmune Retinopathy
Jampol and Fishman
Arch Ophthalmol 2009;127:573-575.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2009 American Medical Association. All Rights Reserved.