TY - JOUR
T1 - Ocular manifestations of systemic amyloidosis
AU - Reynolds, Margaret M.
AU - Veverka, Kevin K.
AU - Gertz, Morie A.
AU - Dispenzieri, Angela
AU - Zeldenrust, Steven R.
AU - Leung, Nelson
AU - Pulido, Jose S.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Purpose: To describe ophthalmic manifestations of systemic amyloidosis, a group of devastating conditions. Methods: A retrospective chart review including patients who had ocular examinations at Mayo Clinic between January 1, 1985, and April 1, 2014, and a diagnosis of light-chain (AL), secondary (AA), or nontransthyretin familial amyloidosis was undertaken. Sixty-eight patients with AL amyloidosis, eight patients with AA amyloidosis, and five patients with nontransthyretin familial amyloidosis were included. Results: Of 68 patients, 8 patients (14 eyes) with AL amyloidosis had ocular involvement secondary to conjunctiva, temporal artery, extraocular muscle, trabecular meshwork, and cranial nerve deposition. One of the five patients with nontransthyretin familial amyloidosis had gelsolin-related corneal dystrophy. No patients with AA amyloidosis (n = 8) had ophthalmic manifestations. Conclusion: Systemic amyloidosis can lead to ocular morbidity. Patients with AL amyloidosis had involvement of the temporal artery, conjunctiva, extraocular muscles, trabecular meshwork, and cranial nerves. Those with gelsolin nontransthyretin familial amyloidosis were susceptible to corneal dystrophy. Patients with AA amyloidosis did not manifest ophthalmic involvement. Finally, if ocular amyloidosis is detected, patients should be referred for systemic workup.
AB - Purpose: To describe ophthalmic manifestations of systemic amyloidosis, a group of devastating conditions. Methods: A retrospective chart review including patients who had ocular examinations at Mayo Clinic between January 1, 1985, and April 1, 2014, and a diagnosis of light-chain (AL), secondary (AA), or nontransthyretin familial amyloidosis was undertaken. Sixty-eight patients with AL amyloidosis, eight patients with AA amyloidosis, and five patients with nontransthyretin familial amyloidosis were included. Results: Of 68 patients, 8 patients (14 eyes) with AL amyloidosis had ocular involvement secondary to conjunctiva, temporal artery, extraocular muscle, trabecular meshwork, and cranial nerve deposition. One of the five patients with nontransthyretin familial amyloidosis had gelsolin-related corneal dystrophy. No patients with AA amyloidosis (n = 8) had ophthalmic manifestations. Conclusion: Systemic amyloidosis can lead to ocular morbidity. Patients with AL amyloidosis had involvement of the temporal artery, conjunctiva, extraocular muscles, trabecular meshwork, and cranial nerves. Those with gelsolin nontransthyretin familial amyloidosis were susceptible to corneal dystrophy. Patients with AA amyloidosis did not manifest ophthalmic involvement. Finally, if ocular amyloidosis is detected, patients should be referred for systemic workup.
KW - ApoA1
KW - ApoA2
KW - Beta-2 microglobulin
KW - Gelsolin
KW - Light-chain (AL) amyloidosis
KW - Lysozyme
KW - Nontransthyretin familial amyloidosis
KW - Secondary (AA) amyloidosis
KW - Serum amyloid A (SAA)
KW - Systemic amyloidosis
UR - http://www.scopus.com/inward/record.url?scp=85049077751&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000001901
DO - 10.1097/IAE.0000000000001901
M3 - Article
C2 - 29068915
AN - SCOPUS:85049077751
SN - 0275-004X
VL - 38
SP - 1371
EP - 1376
JO - Retina
JF - Retina
IS - 7
ER -