Vitreous surgery impact in glaucoma development in liver transplanted familial amyloidosis ATTR V30M Portuguese patients

Abstract

Purpose: 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. Methods: 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. Results: 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). Conclusion: Vitrectomy induced the development of glaucoma in FAP patients.

Keywords::

• Amyloid
• familial amyloidotic polyneuropathy
• glaucoma
• vitrectomy
• vitreous

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.