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Purpose Autoimmune retinopathy (AIR) is a retinopathy associated with unexplained vision loss presumably linked to circulating antiretinal antibodies; currently, however, there are no standardized criteria regarding the diagnosis, treatment strategy, or pathogenesis of this disease. The importance of B-lymphocyte immunophenotyping in the classification of AIR is unknown. Methods We utilized 15-color multiparametric flow cytometry to identify aberrations in B cell subsets that may contribute to the pathophysiology of AIR. Luminex cytokine analysis was also performed on plasma samples from AIR patients. Results Significant differences in AIR patients compared to individuals with other inflammatory conditions or healthy donors were found in the B cell memory compartment, including an increase in naive B cells and a decrease in switched and unswitched memory B cells, which correlated with alterations in immunoglobulin secretion. Conclusions These findings suggest that the maturation process of B cells may be impaired and that B cell immunophenotyping may help in understanding disease process in AIR.

PURPOSE Studies have used central retinal arteriolar (CRAE) and central retinal venular (CRVE) calibers, measured from images produced with computerized image analysis, to detect risk factors for systemic diseases. The authors explored suboptimal image focus as a possible contributing factor to artificially larger vascular caliber measurements. METHODS From the reading center image collections, 30 digital retinal images were selected for optimum quality. Image analysis software was used to derive nine progressively blurred versions of the originals. IVAN measurement software was used to measure CRAE and CRVE in the original and the blurred series derived from them. To check the adequacy of the simulation, progressively defocused series of images were taken of several volunteers. RESULTS For CRAE, each level of simulated blurring produced a statically significant increase in apparent vessel caliber from the original (P

Digital cameras for retinal photography have largely replaced film fundus cameras, in part because of the immediate availability of images and the convenience of their storage, reproduction, and transmission. In addition, commercial film production continues to decrease, and film is likely to be unavailable for retinal photography in the future.1 Digital color fundus photography differs in some potentially important aspects from film photography of the fundus. Digital camera systems for retinal photography vary a great deal with respect to how they handle tonal balance and illumination,2 which may result in differences in evaluation of lesions between film and digital photographs.2 This variation presents challenges with respect to evaluating the images of subtle lesions in eyes with diabetic retinopathy (DR) in multicenter clinical trials. If grading of DR severity between film and digital images differs, there may be consequences for study interpretation. For digital ophthalmic images to be suitable for use in clinical trials evaluating treatment of diabetic eye disease, the sensitivity of diagnosing vascular lesions has to be on a par with the gold-standard modified seven-field (7-field) stereoscopic images, as described in the Early Treatment Diabetic Retinopathy Study (ETDRS) report number 10.3 Some currently available digital camera systems include the option of wide-angle image capture at 45° to 60° (4-field wide protocol), versus the 30° to 35° fields used in conventional 7-field imaging protocols for clinical trials of DR.4 Wide-angle photography offers the possibility of imaging an equivalent area of retina with fewer frames, thereby increasing efficiency and exposing the subject to fewer light flashes. Decreasing the number of images also reduces the total file storage requirement, which may be an important consideration for clinical centers and centralized reading centers. Each uncompressed color image, one side of a stereo pair and independent of angle, is approximately 14 megabytes when obtained with a 6-megapixel digital camera system (14 MB × 14 images for modified 7-field and 14 MB × 8 images for 4-field wide). We compared film and digital images from a subset of Diabetic Retinopathy Clinical Research Network (DRCR.net) clinical centers, to determine the extent of agreement between the grading of these images with respect to diabetic retinal disease assessment, including severity of DR, presence and extent of diabetic macular edema (DME), and clinically significant macular edema (CSME). In addition, we evaluated potential differences in the grading of digital 4-field wide-angle photographs versus digital modified 7-field standard photographs relative to traditional 7-field film grading.