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4.
Arch. Soc. Esp. Oftalmol ; 94(11): 540-544, nov. 2019. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-187410

RESUMO

El objetivo fue presentar un caso de retinopatía autoinmune (AIR) no paraneoplásica con anticuerpos antirecoverina positivos. Una mujer de 28 años consultó por pérdida de la agudeza visual bilateral de 8 meses de evolución. El fondo de ojo presentó un patrón de coloración moteado desde el centro a la periferia, sin espículas pigmentarias. La angiografía mostró un patrón de áreas puntiformes, sin fuga de contraste. Se observó una reducción de las capas externas de la retina en la tomografía de coherencia óptica, mientras que el electrorretinograma mostró una ausencia de respuesta de los conos y los bastones en el ojo derecho, y una respuesta disminuida de los conos con ausencia de respuesta de los bastones en el ojo izquierdo. Se sospechó AIR, y se empezó tratamiento empírico con corticoides a la espera de los resultados del Western-blot, que posteriormente resultó positivo para recoverina, GAPDH, anti-alfa-enolasa y aldolasa. Mientras pudo ser tratada, la agudeza visual se mantuvo estable. Al retirarse el tratamiento, esta se redujo a amaurosis en el ojo derecho y movimiento de manos en el ojo izquierdo


The case is presented of a non-paraneoplastic autoimmune retinopathy (AIR) with positive anti-recoverin autoantibodies. A 28-year-old woman presented with a rapidly progressive bilateral visual loss of 8 months onset. Funduscopic examination revealed diffuse fine mottled atrophic changes in both eyes. Fluorescein angiographic studies showed a pattern of mottled areas of early hyperfluorescence without leakage of dye. In the ocular coherence tomography it was observed that was a loss of external layers. The electroretinogram showed absence of rod and cone responses in the right eye, and diminished cone response associated to absence of rod response in the left eye. AIR was suspected, and empirical corticosteroid treatment was started while waiting for Western-blot results, which was finally positive for recoverin, GAPDH, anti-alpha-enolase, and aldolase. The patient was able to be treated, and her visual acuity remained stable, but as soon as it was suspended, vision was completely lost in the right eye and reduced to hand movement in the left eye


Assuntos
Humanos , Feminino , Adulto , Anticorpos/análise , Doenças Autoimunes/imunologia , Recoverina/imunologia , Doenças Retinianas/imunologia , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Eletrorretinografia , Fundo de Olho , Glucocorticoides/uso terapêutico , Ácido Micofenólico/uso terapêutico , Prednisona/uso terapêutico , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/tratamento farmacológico , Tomografia de Coerência Óptica , Acuidade Visual , Campos Visuais
5.
Arch Soc Esp Oftalmol (Engl Ed) ; 94(11): 540-544, 2019 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31470998

RESUMO

The case is presented of a non-paraneoplastic autoimmune retinopathy (AIR) with positive anti-recoverin autoantibodies. A 28-year-old woman presented with a rapidly progressive bilateral visual loss of 8 months onset. Funduscopic examination revealed diffuse fine mottled atrophic changes in both eyes. Fluorescein angiographic studies showed a pattern of mottled areas of early hyperfluorescence without leakage of dye. In the ocular coherence tomography it was observed that was a loss of external layers. The electroretinogram showed absence of rod and cone responses in the right eye, and diminished cone response associated to absence of rod response in the left eye. AIR was suspected, and empirical corticosteroid treatment was started while waiting for Western-blot results, which was finally positive for recoverin, GAPDH, anti-alpha-enolase, and aldolase. The patient was able to be treated, and her visual acuity remained stable, but as soon as it was suspended, vision was completely lost in the right eye and reduced to hand movement in the left eye.


Assuntos
Anticorpos/análise , Doenças Autoimunes/imunologia , Recoverina/imunologia , Doenças Retinianas/imunologia , Adulto , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Eletrorretinografia , Feminino , Fundo de Olho , Glucocorticoides/uso terapêutico , Humanos , Ácido Micofenólico/uso terapêutico , Prednisona/uso terapêutico , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/tratamento farmacológico , Tomografia de Coerência Óptica , Acuidade Visual , Campos Visuais
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