Early onset vitreous amyloidosis in familial amyloidotic polyneuropathy with a transthyretin Glu54Gly mutation is associated with elevated vitreous VEGF.
OBJECTIVE
To report the early vitreous involvement in a rare familial amyloidotic polyneuropathy (FAP) mutation and associated vitreous vascular endothelial growth factor (VEGF) levels.


METHODS
Observational case series.


METHODS
Review of clinical, pathological, photographic, and angiographic records of two FAP siblings with severe vitreous involvement. Laboratory ELISA analysis of vitreous samples for VEGF, and DNA sequence analysis of peripheral blood for transthyretin (TTR) mutational analysis.


RESULTS
Two patients underwent 25-gauge vitrectomy in three eyes with marked improvement of visual acuity. Neovascularisation seen intraoperatively responded to endolaser. Analysis of vitrectomy samples for VEGF showed raised levels in all three specimens. Mutational analysis revealed an isolated Glu54Gly mutation in the transthyretin gene.


CONCLUSIONS
Early involvement of the vitreous occurs in a rare transthyretin mutation of FAP, with increased vitreous levels of VEGF.
O'Hearn
T M
TM
Retina Service, Eye and Ear Infirmary, University of Illinois, 1855W Taylor St, Suite 2.50, Chicago, IL 60612, USA.
Fawzi
A
A
He
S
S
Rao
N A
NA
Lim
J I
JI
D000328:Adult; D017668:Age of Onset; D028227:Amyloid Neuropathies, Familial / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D044466:Asian People / Q000235:genetics; D015785:Eye Diseases, Hereditary / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D018698:Glutamic Acid; D005998:Glycine; D006801:Humans; D008297:Male; D009154:Mutation; D011228:Prealbumin / Q000235:genetics*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism*
D011228:Prealbumin; D042461:Vascular Endothelial Growth Factor A; D018698:Glutamic Acid; D005998:Glycine