Vitreous opacities in primary amyloid disease

Severe loss of visual acuity due to vitreous opacities may result from haemorrhages, inflammatory and degenerative conditions, tumour cells, or amyloidthe last being rare (Duke-Elder, I969; Jaffe, I969). It is important, however, to recognize amyloid disease as being a cause of vitreous opacities, because most previously reported cases have been patients with familial amyloidosis, a systemic disease of protean manifestations with a poor prognosis. Sporadic cases of systemic amyloidosis with vitreous opacities have also been reported (see Table). Patients with systemic amyloid disease may initially present with visual symptoms due to vitreous opacities. These opacities usually have a characteristic appearance thus enabling the ophthalmologist to suggest the correct diagnosis. The purpose of this paper is to report three patients of primary amyloid disease, who initially presented to the ophthalmologist with slow deterioration of their visual acuity. The diagnosis was suggested by the appearance of the vitreous opacities and confirmed initially by conjunctival biopsy in two of the three cases and subsequently by histological examination of the vitreous in all three cases. To our knowledge, this is the first British report of vitreous opacities in primary amyloid disease.