SCIENTIFIC POSTER_Natalia Ferreira

Purpose:

To report management of de novo vitreous amyloid opacities after previous pars plana vitrectomy in familial amyloidotic polyneuropathy.

Methods:

Retrospective observational consecutive case series of 4 eyes. Demographic data, TTR mutation involved, age at the beginning of disease, period of evolution of disease, liver transplant, time between total vitrectomy and repeat intervention and the corresponding ophthalmological findings were evaluated. Surgical re-intervention included phacoemulsification with intraocular lens implantation in phakic eyes, repeat vitrectomy as complete as possible together with posterior capsulotomy and ILM peeling in case of tractional vitreomacular interface changes.

Results:

All patients were female and had TTR Met30 mutation. Mean age at the onset of ocular symptoms was 56 years and average evolution the underlying disease was 6,5 years. Two patients had had liver transplantation 4 and 9 years before. Time interval between first vitrectomy and surgical reintervention was longer than 2 years in all cases. Amyloid deposits on anterior lens surface and a scalloped pupil was observed in one eye only. One eye has remained phakic and another one had glaucoma. All eyes showed vitreous opacities behind the posterior lens capsule and in the vitreous base. After repeat surgery, no futher recurrence was observed.

Conclusion:

De novo vitreous amyloid opacities may occur several years after pars plana vitrectomy. Amyloid deposits were observed only in areas with vitreous remnants, e.g. where strong vitreous adherences were present (behind the posterior lens capsule and in the vitreous base). Posterior capsulotomy associated with extensive repeat vitrectomy seemed to be effective to prevent de novo amyloid deposits in the vitreous cavity.