Anti-retinal IgG antibodies in patients with early and advanced type 2 macular telangiectasia

Samuel McLenachan; Chandrakumar Balaratnasingam; Rachael C Heath Jeffery; Shang-Chih Chen; Dan Zhang; Geoffrey Chan; Rosa Dolz-Marco; Tommaso Bacci; Johnny Lo; Steven Wiffen; Lawrence A Yannuzzi; Fred K Chen

doi:10.1016/j.exer.2022.109024

Anti-retinal IgG antibodies in patients with early and advanced type 2 macular telangiectasia

Exp Eye Res. 2022 May:218:109024. doi: 10.1016/j.exer.2022.109024. Epub 2022 Mar 8.

Authors

Affiliations

¹ Centre for Ophthalmology and Visual Science, The University of Western Australia, Western Australia, Australia; Lions Eye Institute, Western Australia, Australia.
² Centre for Ophthalmology and Visual Science, The University of Western Australia, Western Australia, Australia; Lions Eye Institute, Western Australia, Australia; Department of Ophthalmology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
³ Centre for Ophthalmology and Visual Science, The University of Western Australia, Western Australia, Australia; Lions Eye Institute, Western Australia, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia.
⁴ Lions Eye Institute, Western Australia, Australia.
⁵ Vitreous, Retina, Macular Consultants of New York and LuEster T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA.
⁶ School of Science, Edith Cowan University, Perth, Western Australia, Australia.
⁷ Lions Eye Institute, Western Australia, Australia; Department of Ophthalmology Fremantle Hospital, Fremantle, Western Australia, Australia.
⁸ Centre for Ophthalmology and Visual Science, The University of Western Australia, Western Australia, Australia; Lions Eye Institute, Western Australia, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia; Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia. Electronic address: fredchen@lei.org.au.

PMID: 35271830
DOI: 10.1016/j.exer.2022.109024

Abstract

Type 2 idiopathic macular telangiectasia (MacTel-2) is a progressive adult-onset macular disease associated with bilateral perifoveal vascular changes, Muller cell degeneration and increased blood-retinal barrier permeability. The pathophysiological mechanisms of MacTel-2 remain unclear, however it was previously reported that anti-retinal antibodies in MacTel-2 patients are a significant feature of the disease. In this study, we aimed to compare the prevalence of anti-retinal antibodies in patients MacTel-2, healthy controls and patients with other retinal diseases. MacTel-2 patients diagnosed with multimodal imaging were enrolled and their disease severities were graded using spectral-domain optical coherence tomography. For comparison, patients with age-related macular degeneration (AMD), inherited retinal diseases (IRDs) or no retinal disease (healthy controls) were recruited as controls. Blood serum samples were screened for immunoglobulin G anti-retinal antibodies by western blotting, followed by densitometry analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated and p < 0.05 considered statistically significant. Overall, anti-retinal antibody-positive cases were older (64 ± 15 vs 53 ± 17 years, p < 0.001) and females were more likely to develop anti-retinal antibodies (OR: 2.41, CI: 1.12-5.18). The frequency of anti-retinal antibody detection in MacTel-2 patients (n = 42, 36%) was not significantly different from healthy controls (n = 52, 25%) or IRD patients (n = 18, 25%) and the majority of MacTel-2 patients had no anti-retinal antibodies. In contrast, the frequency of anti-retinal antibody detection was significantly higher in patients with AMD (n = 15, 73%, p < 0.001). The lack of a greater anti-retinal antibody frequency or specificity in the MacTel-2 cohort suggests that antibody mediated immunological mechanisms may play a less significant role in MacTel-2 disease pathogenesis.

Keywords: AMD; Age-related macular degeneration; Anti-retinal antibodies; Autoantibodies; MacTel-2; Macular telangiectasia; Retinal degeneration; Western blot.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Diabetic Retinopathy* / pathology
Female
Humans
Immunoglobulin G
Macular Degeneration* / pathology
Retina / pathology
Retinal Telangiectasis* / diagnosis
Retinal Telangiectasis* / pathology
Tomography, Optical Coherence / methods

Substances

Immunoglobulin G