Abstract
This chapter deals with the identification of antiretinal immune reactivity in patients with retinal diseases. An extraordinary feature of the eye is its immune status. The immune response that occurs within the eye is different from the systemic immune response, and this unique characteristic has been referred to as immune privilege. Retinal autoimmunity exists as a naturally occurring disease in humans and as an experimentally designed animal model system. Sympathetic ophthalmia (SO) is an ocular inflammatory (autoimmune) disease that occurs after a perforating injury to one eye. Cancer-associated retinopathy (CAR) is most commonly associated with small-cell carcinoma of the lung, but it has also been reported for patients with breast, endometrial, and other cancers. Posterior ocular onchocerciasis is characterized by atrophy of the retinal pigment epithelium (RPE), and as lesions advance, subretinal fibrosis occurs. Toxoplasmosis, which occurs in over 500 million humans worldwide, is caused by the obligate intracellular parasite Toxoplasma gondii. T. gondii is also the most frequently identified infectious agent in posterior uveitis, and Toxoplasma retinochoroiditis is an important cause of blindness in young adults. Measurement of antiretinal immune reactivity is difficult to perform in the clinical laboratory. Analysis of immunocytochemical or immunofluorescent staining of retina tissue sections requires special training for interpretation.
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