Department of Ophthalmology, Amyloid Research Center, Santo Antonio General Hospital, Porto, Portugul.
Retina. 2011 Jul-Aug;31(7):1373-7. doi: 10.1097/IAE.0b013e318203c0c2.
Vitreous amyloid deposits are one of the most common ocular manifestations of familial amyloidosis ATTR V30M (FAP-I), which can be the only manifestation of the disease and can appear even after liver transplantation. Removal by vitrectomy is usually performed, but vitreous amyloid recurrence has been frequently reported. This study was undertaken to evaluate the recurrence of vitreous amyloidosis and its relationship with the degree of previous vitreous removal.
Fifty-four vitrectomized eyes from 32 patients with FAP-I were evaluated in the course of a follow-up period of 30.7 ± 17.2 months (range, 8-78; median = 30 months). An extensive, as possible, vitrectomy with indentation was performed in 41 eyes (complete), and in the others 13 eyes only a vitrectomy without indentation (incomplete) was performed. The parameters evaluated were the incidence of amyloid deposits and visual outcomes.
A noteworthy visual acuity gain was observed, although a few patients had a subsequent decrease of visual acuity related to new vitreous amyloid deposition in the visual axis. These new amyloid deposits did not occur in eyes that had undergone extensive vitreous removal, but only in nonextensive vitrectomized eyes (P < 0.001).
Recurrence of amyloid deposition only occurred in nonextensive vitrectomized eyes and represents a false recurrence associated with incomplete vitrectomy.
玻璃体内淀粉样沉积物是家族性淀粉样变性ATTR V30M（FAP-I）的最常见眼部表现之一，它可能是该疾病的唯一表现，甚至在肝移植后也会出现。通常通过玻璃体切除术进行清除，但已频繁报道玻璃体内淀粉样沉积物的复发。本研究旨在评估玻璃体内淀粉样变性的复发及其与先前玻璃体切除程度的关系。
在 30.7±17.2 个月（范围，8-78；中位数=30 个月）的随访期间，评估了 32 例 FAP-I 患者的 54 只玻璃体切除眼。在 41 只眼中进行了广泛的（尽可能的）玻璃体切除术并进行了内压，而在其余 13 只眼中仅进行了无内压的玻璃体切除术（不完全）。评估的参数是淀粉样沉积物的发生率和视力结果。
观察到显著的视力提高，尽管少数患者的视力随后下降，这与视轴上新的玻璃体内淀粉样沉积物有关。这些新的淀粉样沉积物仅发生在未进行广泛玻璃体切除的眼中，而不在广泛玻璃体切除的眼中发生（P<0.001）。
淀粉样沉积物的复发仅发生在不完全玻璃体切除的眼中，代表与不完全玻璃体切除术相关的假复发。
