Latest Updates on Antiretinal Autoantibodies Associated With Vision Loss and Breast Cancer

Abstract

Cancer-associated retinopathy (CAR) is an uncommon paraneoplastic disorder of the retina that is frequently associated with breast cancer in pre- and postmenopausal women older than 50 years. In this review, we will give an update on the current knowledge regarding the association of antiretinal autoantibodies with the breast-CAR syndrome. Women with breast cancer and visual indications of CAR have a significantly increased incidence of autoantibodies (AAbs) against retinal proteins when compared to healthy women. The onset of visual loss in association with antiretinal AAbs peaks 2 to 3 years after the clinical diagnosis of breast cancer. Differences in severity of symptoms between women with or without antiretinal AAbs are evident, revealing more unfavorable presentation in seropositive women. The incidence of CAR in breast cancer is likely to rise as the survival time of patients with breast cancer increases; consequently, a prediction of breast-CAR based on autoimmunity to individual retinal antigens, or to panels of antigens (signatures), is clinically important.

Cancer-associated retinopathy after surgery for breast cancer: a case report and review of the literature

“…The average age was 56.4 (50–62) years. Adamus et al reported that the onset of CAR in breast cancer was more common among women ≥ 50 of age, around the time of menopause, which is consistent with this study [ 6 ].…”

“…Among the case reports including other tumors to date, CAR has led to the discovery of primary tumors in many cases. However, Adamus et al reported that the anti-retinal cell line antibodies in many breast cancer patients are already expressed before the onset of breast cancer, causing vision disorders 2 or 3 years after the cancer diagnosis, whereas CAR precedes the diagnosis of cancer in only 5% of cases [ 6 ]. One case involved breast cancer with distant metastasis.…”

Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy

“…The 23-kDa protein did not correspond to anti-recoverin antibody. Although recoverin has been historically shown to be a target antigen in CAR the incidence of anti-recoverin antibodies in CAR is very low across different kinds of tumor and ranges between 3% and 5% [18] .…”

Alpha-Enolase i ENO1 i a potential target in novel immunotherapies

“…Circulating anti-ENO1 antibodies have been found in several autoimmune disease such as lupus nephritis (66,67) and autoimmune retinopathy (68) as well as in cancer-associated retinopathy (69,70). In breast cancer patients with associated retinopathy an increased incidence of autoantibodies in general has been observed (71,72). Moreover, antibodies against citrullinated ENO1 epitopes were observed in rheumatoid arthritis patients (73,74).…”