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Ocular amyloidosis and secondary glaucoma
G A Nelson1, D P Edward, J T Wilensky
1Department of Ophthalmology and Visual Sciences, University of Illinois-Chicago, USA.
Ophthalmology
|July 16, 1999
Summary
Secondary glaucoma in amyloidosis can have varied causes, often resisting medical treatment. Surgical outcomes require careful conjunctival management due to potential complications.
Area of Science:
- Ophthalmology
- Pathology
- Genetics
Background:
- Amyloidosis is a rare condition characterized by the deposition of amyloid proteins in various tissues.
- Secondary glaucoma is a form of glaucoma caused by an underlying medical condition or disease.
Observation:
- Two distinct cases of secondary glaucoma associated with amyloidosis are presented.
- One case involved orbital amyloidosis with elevated episcleral venous pressure, while the other had familial amyloid neuropathy with transthyretin mutation.
Findings:
- Both patients experienced elevated intraocular pressure (IOP) poorly responsive to medical therapy, necessitating filtration surgery.
- Histopathology revealed perivascular amyloid deposits in one case and amyloid in the aqueous and on the lens in the other.
- Conjunctival buttonholing complicated surgery in both cases, but leaks resolved with IOP control.
Implications:
- Glaucoma secondary to amyloidosis can arise from diverse pathophysiologic mechanisms, including elevated episcleral venous pressure and outflow obstruction.
- Elevated IOP in these cases may not respond effectively to conventional medical treatments.
- Careful surgical techniques are crucial when managing the conjunctiva in patients with amyloid-associated glaucoma.