Background: 

Over the past decade, there has been a remarkable advancement in the understanding of autoimmune etiologies of encephalitis. The first identified generation of paraneoplastic encephalitis tends to occur in older populations, responds poorly to immunotherapy, and is mediated by T-cell damage with antibodies directed toward intracellular antigens. A new generation of autoimmune encephalitides has been described, which are mediated by antibodies to cell-surface proteins, tend to occur in younger individuals, are less frequently associated with malignancy, and often respond better to treatment compared to their intracellular antigen-related paraneoplastic counterparts. This review will focus on several specific antibody-mediated autoimmune encephalitides with neuro-ophthalmic pertinence.

Evidence Acquisition: 

Literature review and personal clinical experience.

Results: 

Several of the antibody-mediated encephalitides, specifically N-methyl-D-aspartate receptor, dipeptidyl-peptidase-like protein 6, glial fibrillary acidic protein, metabotropic glutamate receptor 1 (mGluR1), gamma-aminobutyric acid receptor, glutamic acid decarboxylase 65 (GAD65), collapsing response mediator protein 5 (CRMP5), and kelch-like protein 11 (KLHL11), contain features of neuro-ophthalmic interest.

Conclusions: 

The novel cell-surface protein-directed autoimmune encephalitis group can present with a wide range of afferent and efferent neuro-ophthalmic manifestations. Neuro-ophthalmologists should be familiar with these antibody-associated syndromes, which are treatable and often require a high index of suspicion for diagnosis.

中文翻译：

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自身免疫性脑炎的神经眼科特征。

背景： 

在过去的十年中，对脑炎自身免疫病因的理解取得了显着进步。第一代被发现的副肿瘤性脑炎往往发生在老年人群中，对免疫疗法的反应很差，并且由 T 细胞损伤和针对细胞内抗原的抗体介导。已经描述了新一代自身免疫性脑炎，其由细胞表面蛋白抗体介导，往往发生在年轻个体中，与恶性肿瘤相关的频率较低，并且与细胞内抗原相关的副肿瘤对应物相比，通常对治疗反应更好. 本综述将重点介绍几种具有神经眼科相关性的特异性抗体介导的自身免疫性脑炎。

取证： 

文献回顾和个人临床经验。

结果： 

几种抗体介导的脑炎，特别是 N-甲基-D-天冬氨酸受体、二肽基-肽酶样蛋白 6、胶质纤维酸性蛋白、代谢型谷氨酸受体 1 (mGluR1)、γ-氨基丁酸受体、谷氨酸脱羧酶 65（ GAD65)、塌陷反应介质蛋白 5 (CRMP5) 和 kelch 样蛋白 11 (KLHL11) 包含神经眼科感兴趣的特征。

结论： 

新型细胞表面蛋白导向的自身免疫性脑炎组可出现广泛的传入和传出神经眼科表现。神经眼科医生应该熟悉这些抗体相关综合征，这些综合征是可以治疗的，并且通常需要高度怀疑才能进行诊断。