Antineutrophil cytoplasmic antibodies in chronic idiopathic intraocular inflammatory disease

Antineutrophil cytoplasmic antibodies (ANCA) are found in the sera of patients with Wegener's granulomatosis and other systemic necrotising vasculitides. Antibody levels correlate closely with disease activity so that follow-up of ANCA titres might be helpful in guiding therapy. The authors assessed in a cohort of patients with chronic ocular inflammatory disease ANCA titres prospectively over a two-year period, by an indirect immunofluorescent technique. They found that sera from 10/64 patients (15.6%) stained positive for c-ANCA antibodies, and none stained for p-ANCA. Six c-ANCA positive patients had one or more clinical relapses (range one to three) during this study period. Each relapse correlated with a rise in ANCA titre. The remaining four patients who were found to have persistently low titres of c-ANCA had no clinical relapses. The authors conclude that although c-ANCA is only present in a small proportion of patients with idiopathic chronic intraocular inflammatory disease, the ANCA titre may be used to monitor disease activity in this group of patients. Further study to assess the potential of c-ANCA titres in predicting disease relapse is indicated, which in the future may minimise the side effects of currently used immunosuppressive therapies.