Ocular amyloidosis: clinical points learned from one case

The etiology of bilateral vitreous opacification in a 72-year-old man was undiagnosed until after a second vitrectomy when the aspirate was tested with Congo red and found to stain for amyloid. Failure to recognize the significance of a mild peripheral neuropathy delayed the diagnosis. Visual acuity OU remained 20/40 for one year after completion of multiple ocular surgeries. Experience from this case suggests that amyloidosis should be considered in all patients with unexplained vitreous infiltration. A conjunctival biopsy may be helpful diagnostically, and removal of as much cortical and retrolental vitreous as is safe may reduce the incidence of reopacification.