Lezrek M, Dahreddine M, Bencherif Z, Karim A, Maher M, Tachfouti S, Karmane A, Mohcine Z
Service d'Ophtalmologie A, Hôpital des Spécialités, Rabat, Morocco.
J Fr Ophtalmol. 2007 Jun;30(6):e17. doi: 10.1016/s0181-5512(07)89672-0.
Ocular amyloidosis is infrequent, and the palpebral location is uncommon. It usually has a primary localized form, but can occur in systemic or familial amyloidosis. The diagnosis is mainly made by histopathology. Its treatment is surgical and the prognosis depends on clinical presentation and recurrences. We report the case of a 54-year-old woman with no medical history of the disease, who had bilateral isolated palpebral amyloidosis presenting as bilateral upper lid swelling with ptosis and corneal dystrophy. Diagnosis was confirmed by palpebral biopsy and the patient underwent excision of the involved lid tissue with reconstruction of the affected lid with cartilage autograft. Clinical progression showed improvement of the ptosis and the patient's comfort. Although rare, palpebral amyloidosis poses management problems, particularly in advanced cases, because of corneal complications and recurrence.
眼部淀粉样变性并不常见,睑部受累的情况则更为罕见。它通常表现为原发性局限性形式,但也可发生于全身性或家族性淀粉样变性。诊断主要依靠组织病理学检查。其治疗方法为手术治疗,预后取决于临床表现和复发情况。我们报告一例54岁女性患者,既往无该疾病病史,双侧孤立性睑部淀粉样变性表现为双侧上睑肿胀伴上睑下垂及角膜营养不良。睑部活检确诊后,患者接受了受累眼睑组织切除,并采用自体软骨移植对患侧眼睑进行重建。临床进展显示上睑下垂有所改善,患者舒适度提高。尽管睑部淀粉样变性罕见,但由于角膜并发症和复发问题,尤其是在晚期病例中,会带来治疗难题。