Opthalmology Department, Hospital de Santo António-Centro Hospitalar do Porto, Porto, Portugal.
Amyloid. 2012 Sep;19(3):146-51. doi: 10.3109/13506129.2012.710669. Epub 2012 Aug 3.
Familial amyloidosis with polyneuropathy (FAP) sometimes courses with vitreous amyloid. The aim of this study was to evaluate the incidence of glaucoma after vitrectomy in FAP patients.
A total of 79 eyes of 42 liver transplanted FAP patients and 16 eyes of 16 non-FAP patients with rhegmatogenous retina detachment were collected. The patients were divided in to three groups: Group I - FAP patients with vitreous opacities submitted to vitrectomy, Group II - FAP patients without vitreous opacities and not submitted to vitrectomy and, Group III - non-FAP patients with rhegmatogenous retinal detachment submitted to vitrectomy. The Group I was subdivided into: Ia - "complete" vitrectomy; Ib - "incomplete" vitrectomy. The onset of glaucoma was considered when the intraocular pressure level was higher than 21 mmHg, with concomitant visual field abnormalities and optic nerve cupping.
Post vitrectomy glaucoma was more frequent in Group I (56.1%) than in Group III (12.5%) and in Group II (10.5%). We observed a higher incidence of glaucoma in the Ia than in the Ib subgroup (86.4 vs. 21.1%) and earlier appearance in subgroup Ia (7.9 ± 3.6 vs. 39.5 ± 6.6 months).
Vitrectomy induced the development of glaucoma in FAP patients.
多发性神经淀粉样变伴有玻璃体淀粉样变性（FAP）有时会并发玻璃体内淀粉样变性。本研究旨在评估 FAP 患者玻璃体切除术后青光眼的发生率。
共收集了 42 例肝移植的 FAP 患者的 79 只眼和 16 例非 FAP 患者的 16 只眼，这些患者因孔源性视网膜脱离而接受玻璃体切除术。患者被分为三组：I 组 - 有玻璃体混浊并接受玻璃体切除术的 FAP 患者，II 组 - 无玻璃体混浊且未接受玻璃体切除术的 FAP 患者，III 组 - 接受玻璃体切除术的非 FAP 孔源性视网膜脱离患者。I 组又分为 Ia 组 - “完全”玻璃体切除术；Ib 组 - “不完全”玻璃体切除术。当眼内压水平高于 21mmHg，伴有视野异常和视神经杯状凹陷时，认为发生了青光眼。
玻璃体切除术后青光眼在 I 组（56.1%）比在 III 组（12.5%）和 II 组（10.5%）更为常见。我们观察到 Ia 亚组的青光眼发病率高于 Ib 亚组（86.4%比 21.1%），且 Ia 亚组的发病时间更早（7.9±3.6 比 39.5±6.6 个月）。
玻璃体切除术可诱发 FAP 患者发生青光眼。
