Abstract:   Autoimmune retinopathy (AIR) is a rare, immune-mediated retinal degenerative disease that can lead to progressive vision impairment and even severe vision loss. Due to the lack of specific diagnostic indicators and the overlap of its clinical presentation with inherited retinal degeneration (IRD) and certain inflammatory retinal diseases, AIR is often misdiagnosed or underdiagnosed in clinical practice. Anti-retinal antibodies (ARA) are considered an important laboratory basis supporting the immune-mediated mechanism of AIR, but the clinical interpretation of their detection results remains controversial. The 2025 American Academy of Ophthalmology task force published a new diagnostic framework based on the "likelihood of disease", providing new insights for the clinical recognition and management of AIR. This article, combining this framework and the author’s long-term clinical and research experience, reconsiders and discusses the clinical identification, interpretation of antibody testing, diagnostic stratification, and treatment strategies for AIR. This article proposes that multimodal imaging is an essential tool for disease diagnosis; ARA testing remains an indispensable laboratory criterion but should be interpreted in the clinical context; clinical decision-making should be based on the overall assessment of disease progression and diagnostic likelihood, with treatment goals focused on stabilizing the disease and delaying further visual deterioration. The rational application of the new diagnostic approach and enhanced dynamic follow-up will help improve diagnostic accuracy and reduce overdiagnosis and unnecessary treatment.

Key words: Autoimmune retinopathy, New framework of diagnosis and treatment, Multimodality image, Anti-retinal antibody