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CLINICAL SCIENCES Anti–Retinal Pigment Epithelium Antibodies in Acute Exudative Polymorphous Vitelliform Maculopathy A New Hypothesis About Disease Pathogenesis Larry Koreen, MD, PhD, MPH; Shirley X. He, MD; Mark W. Johnson, MD; Richard E. Hackel, MA; Naheed W. Khan, PhD; John R. Heckenlively, MD Objective: To investigate the etiology of acute exuda- tract demonstrated several antiretinal antibodies, as well tive polymorphous vitelliform maculopathy (AEPVM) in as anti-RPE antibodies against a 26-kDa protein that was a patient with metastatic melanoma, undiagnosed at ini- identified as peroxiredoxin 3 (PRDX3). Serum reactiv- tial examination, by testing for autoimmune mechanisms. ity against PRDX3 was greatly decreased in the conva- lescent-stage serum sample compared with the acute- stage serum sample, while results of retinal extract Methods: Serum samples were obtained from a 50-year- Western immunoblots remained essentially un- old man with AEPVM and metastatic unknown primary changed. Five separate serum samples from partici- melanoma during the acute stage and 3 years later when pants without AEPVM had no autoantibodies against subretinal fluid had resolved and melanoma was in re- PRDX3. mission (AEPVM convalescent stage). Western immu- noblots using both serum samples against human do- Conclusions: Paraneoplastic autoimmune reaction nor retinal extract and cultured primary human
JAMA Ophthalmology – American Medical Association
Published: Jan 1, 2011
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