Antiopsineantistoffen

Antiopsineantistoffen, or anti-opsin antibodies, are autoantibodies directed against opsin proteins in retinal photoreceptor cells. Opsins are light-sensitive pigments found in rods (rhodopsin) and cones (cone opsins). Anti-opsin antibodies have been described primarily in the context of autoimmune retinopathies and paraneoplastic syndromes, though their exact pathogenic role remains under study.

Pathophysiology and significance are not fully established. Binding of anti-opsin antibodies to retinal opsins can potentially interfere with phototransduction or promote immune-mediated photoreceptor damage. The presence of these antibodies often accompanies functional retinal impairment, with variable findings on electroretinography and imaging. It is common for anti-opsin antibodies to be detected alongside other retinal autoantibodies, particularly in paraneoplastic contexts.

Clinical features typically include progressive, bilateral visual disturbance, such as reduced acuity, night vision difficulties, photopsias, and constricted visual fields. The course is heterogeneous and may be associated with underlying cancer or inflammatory ocular disease. Because the antibodies may be present in non-specific autoimmune conditions, establishing a direct causal link to vision loss can be challenging.

Diagnosis relies on a combination of clinical assessment and laboratory testing. Suspected cases may undergo serum or aqueous humor testing using immunoassays against purified opsin antigens or retinal tissue, often complemented by immunofluorescence methods. Functional testing with electroretinography and structural imaging (e.g., optical coherence tomography) helps document photoreceptor dysfunction and progression. There are no universally accepted diagnostic criteria for anti-opsin antibodies alone; interpretation should consider the clinical context and other retinal autoimmune markers.

Treatment focuses on addressing any underlying condition, such as cancer, when present, and on immunomodulatory therapy in select cases. Therapeutic approaches may include corticosteroids, intravenous immunoglobulin, plasmapheresis, or rituximab, with outcomes variable and prognosis dependent on timeliness and response.