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

Purpose: To report a case of psychogenic vision loss caused by false-positive anti-retinal antibody testing. Methods: 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. Results: 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. Conclusions: 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.