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Daisuke Eiki, Takahiro Kawaji, Yukio Ando, Hidenobu Tanihara; Effect of Panretinal Photocoagulation on Ocular Amyloidosis Associated with Transthyretin related-Familial Amyloidotic Polyneuropathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3908.
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Transthyretin (TTR)-related familial amyloidotic polyneuropathy (FAP) generally has some ocular manifestations and, especially, glaucoma often follows vitreous opacities. We previously reported that panretinal laser photocoagulation (PRP) clearly prevented progression of vitreous amyloidosis in 2 cases as a pilot study. The aim of this study is to investigate the effect of PRP on more number of TTR-related Japanese FAP patients.
Twenty-four eyes of 14 TTR-related FAP patients who underwent PRP therapy with 3-year follow-up were enrolled in this study. All patients have amyloidogenic TTR Val30Met mutation. We assessed a change of best corrected visual acuity (BCVA), intraocular pressure (IOP), progression of vitreous opacities and glaucoma before PRP and at 3 years after PRP.
The mean period from the onset of FAP to PRP treatment was 10.7 (range, 1.2-19.2) years. At the time of PRP, vitreous opacities and glaucoma were found in 13 eyes (54.7%) and 7 eyes (24.1%), respectively. At 3 years after PRP, vitreous opacities and glaucoma were found in 17 eyes (70.8%) and 9 eyes (34.5%), respectively. In follow-up period after PRP, five eyes (20.8%) showed progression of vitreous opacities, and 9 eyes (37.5%) showed progression of glaucoma. Only one of 5 eyes with progressive vitreous opacities had decrease its BCVA more than 0.3 logMAR. In cases who had glaucoma at the time of PRP, especially, all of eyes showed progression of glaucoma. Mean BCVA did not change significantly between at the time of PRP and last visit.
PRP may mitigate the progression of vitreous opacities, but did not have an enough effect of halting the progression of glaucoma in eyes with TTR-related FAP. Patients with early stage of ocular manifestations may be good indication of PRP treatment.
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