Consensus on the Diagnosis and Management of Nonparaneoplastic Autoimmune Retinopathy Using a Modified Delphi Approach

Abstract

In a recent issue of the Journal, Fox and associates published a consensus statement on the diagnosis and management of autoimmune retinopathy (AIR). 1 Fox A.R. Gordon L.K. Heckenlively J.R. et al. Consensus on the diagnosis and management of nonparaneoplastic autoimmune retinopathy using a modified Delphi approach. Am J Ophthalmol. 2016; 168: 183-190 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar The authors should be commended on their historic international collaborative effort addressing this enigmatic disease. In their article, the authors have defined the presence of serum antiretinal antibodies (ARAs) as an essential diagnostic criterion for AIR. 1 Fox A.R. Gordon L.K. Heckenlively J.R. et al. Consensus on the diagnosis and management of nonparaneoplastic autoimmune retinopathy using a modified Delphi approach. Am J Ophthalmol. 2016; 168: 183-190 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar Recent papers have highlighted many of the uncertainties related to ARA testing. 2 Forooghian F. The uncertainty regarding antiretinal antibodies. JAMA Ophthalmol. 2015; 133: 744-745 Crossref PubMed Scopus (14) Google Scholar , 3 Forooghian F. Cao S. Cui J. Matsubara J.A. The enigma of autoimmune retinopathy. Int Ophthalmol Clin. 2015; 55: 81-91 Crossref PubMed Scopus (16) Google Scholar As these papers were not referenced or discussed by the authors, a brief discussion of the problems with ARA testing that were raised in these papers is warranted. Consensus on the Diagnosis and Management of Nonparaneoplastic Autoimmune Retinopathy Using a Modified Delphi ApproachAmerican Journal of OphthalmologyVol. 168PreviewTo develop diagnostic criteria for nonparaneoplastic autoimmune retinopathy (AIR) through expert panel consensus and to examine treatment patterns among clinical experts. Full-Text PDF ReplyAmerican Journal of OphthalmologyVol. 170PreviewWe thank Dr Forooghian for his correspondence in regard to our recent article, “Consensus on the Diagnosis and Management of Nonparaneoplastic Autoimmune Retinopathy Using a Modified Delphi Approach.”1 We agree with him that much remains to be achieved in the realm of detecting antiretinal antibodies (ARA) in a standardized, sensitive, and specific method in order for ARA testing to be clinically useful and relevant. Full-Text PDF