The clinical importance of the neonatal Fc receptor in RPE.

IgG levels in the vitreous are used to diagnose ocular infections
(Goldmann-Witmer) and recently anti-VEGFs (Avastin, Lucentis) have been
introduced to treat neovascular age related macular degeneration (ARMD). In the
near future other immunoglobulin based biologicals will be injected in the eye.
Monoclonal anti-TNF antibodies such as Remicade and Humira are promising
candidates for local administration and also cytotoxic monoclonals like
rituximab - for treating ocular lymphomas - are to be injected locally.
However, knowledge about metabolism of IgG in the eye is scarce. Investigation
of the metabolism and transport mechanisms of these antibodies is therefore
warranted.
Mutations or polymorphisms of the FcRn gene may indicate a predisposition for
ARMD. The fact that IgG is found in drusen and in retinal pigment epithelial
(RPE) cells adjacent to drusen indicates a possible role for IgG and therefore
the neonatal Fc receptor (FcRn) in the development of ARMD.

1) To demonstrate that the FcRn functions as a transporter and protector for
vitreous IgG and monoclonals (Avastin, Lucentis) and show that monoclonal
therapeutic antibodies are transported over the RPE via the FcRn. 2) To
investigate if polymorphisms or mutations in the FcRn gene or promoter are
related to ARMD.

1) laboratory research and 2) observational cohort study.

Participants do not benefit from this study. Risks are negligible.