RETINAL VASCULITIS ASSOCIATED WITH TYPE M2 ANTIMITOCHONDRIAL ANTIBODIES.
Axelle M Cools, Bert Maertens, Karen De Letter et al.
✦ AI-curated · Sources linked
Case in brief
A 35-year-old woman presented with photopsia but no reduction in visual acuity. Examination showed bilateral retinal vasculitis, predominantly venous and more extensive in the left eye, involving both central and peripheral veins without occlusion. Broad systemic investigations were unremarkable apart from type M2 antimitochondrial antibody positivity; assessment found no cholestasis or associated connective tissue disease. The vasculitis responded favorably to systemic steroids with adjunctive mycophenolate mofetil. Hepatic function monitoring was arranged because of the substantial risk of developing primary biliary cholangitis.
What made this case unusual
The case links bilateral, nonocclusive retinal vasculitis with type M2 antimitochondrial antibody positivity despite no evidence of cholestasis or connective tissue disease. Whether the antibodies contribute directly to the vasculitis or are incidental remains uncertain.
Diagnostic / clinical pearl
In retinal vasculitis with otherwise unrevealing systemic investigations, type M2 antimitochondrial antibody positivity may be relevant; assess for cholestasis and associated disease, while recognizing that a direct pathogenic role is unproven.