29. Non-Neoplastic Autoimmune Retinopathy

Medical History

A 60-year-old male patient with progressive vision loss in both eyes was examined in our clinic.

Diabetes mellitus (-)
Systemic hypertension (+)
Family history (-)
Smoking (-)
Trauma (-)

Examination Findings

Best corrected visual acuity was 8/10 in the right eye 3/10 in the left eye. Intraocular pressure was 10 mmHg in both eyes. Anterior segment and fundus examination were unremarkable in both eyes. Ishihara color vision test was normal in both eyes.

Color fundus imaging shows no abnormality in both eyes (Figure 1).

Figure 1A
Figure 1B

Infrared reflectance imaging shows no abnormality in both eyes (Figure 2)

Figure 2A
Figure 2B

Fundus autofluorescence imaging shows no abnormality in both eyes (Figure 3)

Figure 3A
Figure 3B

In the MP-1 Microperimetry test, retinal sensitivity was decreased in both eyes. Fixation was central and stable. Absolute scotoma area was not observed (Figure 4).

Figure 4A
Figure 4B

Electrophysiological testing

Pattern and flash VEP: Normal

ERG: A slight decrease in scotopic b wave amplitude, photopic responses are normal

EOG: Normal

mfERG: Disruption of waveforms in both eyes.

SD-OCT imaging shows disruption of photoreceptor layer in both eyes (Figure 5)

Figure 5A
Figure 5B

Anti Retinal Autoantibodies (+)

(WB Anti Retinal Autoantibody, WB Anti Optic Nerve Autoantibody, IHC Anti Retinal Autoantibody)

Differential Diagnosis

Cancer associated autoimmune retinopathy 

The patient was directed to the oncology. No malignant tumors were detected in the systemic evaluation.


Non-Neoplastic Autoimmune Retinopathy


  1. Uludag G, Onal S, Arf S, Sayman Muslubas I, Selcukbiricik F, Koc Akbay A, Molinas Mandel N.  Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy. Am J Ophthalmol Case Rep. 2016 30;2:4-7. 

doi: 10.1016/j.ajoc.2016.03.007




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