False-positive anti-retinal antibodies as a cause of psychogenic vision loss

To report a case of psychogenic vision loss caused by false-positive anti-retinal antibody testing.

We describe a case of visual and systemic symptoms following anti-retinal antibody detection. The case was analyzed for clinical presentation, diagnosis, and consequences of false-positive testing.

The patient presented with decreased vision without detectable pathology on ophthalmic examination. Tests were ordered in search of a diagnosis, including an antibody test. Following detection of anti-retinal antibodies, the patient developed worsening visual symptoms and systemic manifestations. A repeat antibody test performed at our institution revealed negative results, which, in conjunction with lack of visual field expansion, confirmed our suspicion of psychogenic vision loss.

Laboratory screening may be limited by test specificity and can lead to false-positive results, affecting the patient psychologically and clinically. Care must be taken in patients with positive anti-retinal antibodies to ensure the presence of definitive disease before initiation of treatment.