Ophthalmology in China ›› 2026, Vol. 35 ›› Issue (3): 197-202.doi: 10.13281/j.cnki.issn.1004-4469.2026.03.003

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Expression of serum anti-retinal antibodies in the autoimmune retinopathy and their association with clinical features

Huang Junkai1, Liu Qian2, Zhang Zijun2, Cao Kai2, Zhang Jingxue2, Zeng Huiyang2   

  1. 1 School of Biomedical Engineering, Capital Medical University, Beijing 100069;  2 Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, Beijing 100730; 
  • Received:2025-09-26 Online:2026-05-25 Published:2026-05-25
  • Contact: Zeng Huiyang, Email: zhydr@hotmail.com
  • Supported by:
    National Natural Science Foundation of China (81100675); Beijing Municipal Natural Science Foundation (7192034); Key Research Program of Beijing Institute of Ophthalmology (2019006)

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Abstract: Purpose To investigate the expression of serum anti-retinal antibodies (ARAs) in a large cohort of patients with autoimmune retinopathy (AIR) and to explore their association with clinical features. Design Prospective comparative case series. Participants Patients with confirmed AIR, disease controls with retinitis pigmentosa (RP), and healthy controls. Methods  From September 2019 to February 2025, 148 clinically highly suspected AIR patients, 50 RP patients, and 59 healthy individuals presenting to Beijing Tongren Hospital were enrolled. Serum ARAs were detected using immunoblotting, including the total number of antibodies (band counts) and the presence of antibodies against recoverin, α-enolase, and carbonic anhydrase II (CA-II). Analyses were performed to compare ARA expression among groups and to assess correlations between ARAs and clinical features in AIR patients, including best-corrected visual acuity (BCVA), central retinal thickness, visual field, and electroretinogram (ERG). Main Outcome Measures  ARAs, BCVA, central retinal thickness, visual field, and ERG. Results Serological testing verified that all 148 clinically suspected cases were positive for ARAs and were ultimately confirmed as AIR.  Except for α-enolase antibodies（P=0.0126）, there were no statistically significant differences in the total number of ARAs or in the antibodies against recoverin or CA-II between AIR patients and either disease or healthy controls (P value was 0.1780、0.1056 and 0.5476 respectively). Anti-α-enolase positivity was significantly higher in the AIR patients than in the disease (P=0.010) and healthy controls (P=0.018).The number and types of positive antibodies were not significantly associated with disease diagnosis. In AIR patients, recoverin and α-enolase antibodies were correlated with prolonged ERG a-wave implicit time (β=501.01，P=0.0001) and decreased central retinal thickness (β=-0.0401，P=0.013 ), respectively. Conclusions  Serum ARAs alone have limited diagnostic value for AIR and must be interpreted in conjunction with clinical features. Certain ARA subtypes may contribute to AIR pathogenesis and are associated with disease severity. 

Key words:  Autoimmune retinopathy, Antiretinal antibody