CASE REPORTS   

Minerva Oftalmologica 2008 June;50(2):63-7

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Isolated Conjunctival Amyloidosis. Case report

Scalinci S. Z. ¹, Scorolli L. ¹, Autolitano M. ¹, Pieri M. ¹, Greco P. ¹, Morara M. ¹, Meduri A. ¹, Salfi N. C. M. ², Vasuri F. ², Meduri R. A. ¹

¹ Department of Pathophysiological Optics S. Orsola-Malpighi Hospital University of Bologna, Bologna, Italy 2 Department of Anathomic Pathology S. Orsola-Malpighi Hospital University of Bologna, Bologna, Italy

Amyloidosis is a group of disorders characterized by the deposition of an extracellular protein, denominated amyloid, in an abnormal fibrillar form with highly characteristic histopatologic staining properties. The clinical presentation can vary from a focal, localized lesion where amyloidosis has minor clinical consequences, to extensive systemic disease that can involve almost any organ system of the body, leading to severe phatophysiologic damage. Likewise, in eye, amyloidosis can occur as a localized mass or as a part of a systemic disorder. Conjunctival amyloidosis generally is an uncommon condition that rarely is associated with systemic involvement. Generally it is manifestation of a immunologic disorder. We present a patient with conjunctival amyloidosis who was referred to us with the suspicion of another conjunctival lesion. Anterior segment examination of the both eyes showed papilla metaplasia of lower eyelid hepithelium in the left eye. Diagnosis of primary conjunctival amyloidosis was made on incisional biopsy and negative systemic work-up. Patient was treated in left eyes by surgery excision of lower conjunctival fornix. After 6 months of follow-up the patient is asymptomatic without ocular recurrence or evidence of systemic manifestations. The presentation of amyloidosis may be atypical. Ophthalmologists should consider a diagnosis of amyloidosis in patients with periorbital bleeding, even if biopsies are negative for Congo red. A conjunctival biopsy may be useful in establishing a diagnosis of primary systemic amyloidosis.