[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-432147-105":59,"doc-detail-432147-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","intraocular-amyloidosis-presenting-with-secondary-glaucoma-a-clinical-pathologic-report-and-literature-review","Intraocular amyloidosis presenting with secondary glaucoma - a clinical-pathologic report and literature review","","Case report and literature review describing intraocular amyloidosis manifesting as secondary glaucoma, emphasizing clinical features and pathologic correlates. A 72-year-old man developed medically intractable intraocular pressure elevations with unremarkable anterior segment findings but marked vitreous opacities; tube shunt surgery was performed, and subsequent pars plana vitrectomy showed amyloid aggregates. Mass spectrometry identified transthyretin-type amyloid (ATTR). Despite absent systemic findings, the review highlights vitreous amyloidosis as linked to hereditary TTR mutation and supports a low threshold for biopsy when standard therapies fail.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/intraocular-amyloidosis-presenting-with-secondary-glaucoma-a-clinical-pathologic-report-and-literature-review/432147/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/intraocular-amyloidosis-presenting-with-secondary-glaucoma-a-clinical-pathologic-report-and-literature-review/432147.png","ImageObject",300,407,{"name":92,"@type":93},"Dipper","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical presentation suggests secondary glaucoma due to intraocular amyloidosis?","Question",{"text":113,"@type":114},"The case describes medically intractable elevations of intraocular pressure with an unremarkable anterior segment and significant vitreous opacities, which is a relatively uncommon presentation for this cause.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the type of amyloid determined in the report?",{"text":118,"@type":114},"Amyloid aggregates identified on histology were further characterized by mass spectrometric analysis, which revealed transthyretin-type amyloid (ATTR).",{"name":120,"@type":111,"acceptedAnswer":121},"Why is a low threshold for biopsy recommended?",{"text":122,"@type":114},"When common ophthalmologic presentations fail to respond appropriately to standard therapies—especially with atypical exam findings—biopsy helps reveal acellular amyloid deposits and guides further work-up for systemic or hereditary associations.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},432147,1791128362,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","American Journal of Ophthalmology Case Reports 41 (2026) 102501  \nContents lists available at ScienceDirect  \nAmerican Journal of Ophthalmology Case Reports  \njournal [homepage:](homepage: www.ajocasereports.com/)[ www.ajocasereports.com/](homepage: www.ajocasereports.com/)  \n| Intraocular amyloidosis presenting with secondary glaucoma: a clinical-pathologic report and literature review\u003Cbr>Joseph B. Lina , James C. Liu a , Rajendra S. Aptea,b, George J. Harocoposa,c,* \u003Cbr>a Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA b Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA\u003Cbr>c Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, Missouri, USA |  |\n| --- | --- |\n| A R T I C L E I N F O\u003Cbr>Keywords: Amyloid Glaucoma\u003Cbr>Vitrectomy | A B S T R A C T\u003Cbr>Purpose: We describe a case of intraocular amyloidosis presenting as secondary glaucoma, highlighting the clinical presentation and pathologic correlates. We also review the medical literature on all prior reported cases and discuss the diagnostic challenges pertinent to this particular case.\u003Cbr>Observations: We report the case of a 72-year-old man presenting with medically intractable elevations of intraocular pressure. On clinical examination, the anterior segment was unremarkable, but there were significant vitreous opacities. The patient underwent tube shunt surgery, and a simultaneous aqueous humor biopsy was acellular and nondiagnostic. A subsequent pars plana vitrectomy demonstrated amyloid aggregates on histology. Mass spectrometric analysis revealed that this was transthyretin-type amyloid (ATTR), which is associated with a hereditary mutation in the transthyretin (TTR) gene, yet systemic evaluation was unremarkable, and our patient has not yet chosen to pursue genetic testing.\u003Cbr>Conclusions and importance: Amyloid can deposit in nearly all ocular tissues, and it should be suspected when common ophthalmological presentations do not respond appropriately to standard medical therapies. The challenge in this case was that the anterior segment examination was unremarkable, which is a relatively uncommon presentation for secondary glaucoma in the setting of intraocular amyloidosis. Furthermore, unlike the vast majority of cases of glaucoma associated with intraocular amyloidosis reported to date, our patient had no family history of amyloidosis, nor was any evidence of systemic amyloidosis found upon screening. Literature review, however, establishes that vitreous amyloidosis is invariably associated with a hereditary transthyretin (TTR) mutation, even in the relatively uncommon cases presenting without any known family history and without any systemic symptoms. In the appropriate circumstances, a low threshold to biopsy is appropriate. |\n\n1. Introduction  \nAmyloidosis is characterized by the deposition of proteins in a β-pleated sheet configuration. The site of deposits will determine the presenting symptom and can involve the kidneys (nephrotic syndrome), heart (restrictive cardiomyopathy), carpal tunnel (median nerve compression) or other nerves (sensory, motor, autonomic), among others. Thirty-six subtypes of amyloid fibrils have been described, and of the amyloidoses associated with the various subtypes, some are systemic and others localized, some hereditary and others acquired. Amyloidosis can occur in the context of systemic protein hyperabundance, such as in plasma cell dyscrasias (AL/AH), chronic inflammation (AA), hereditary transthyretin accumulation (ATTR), and chronic dialysis (Aβ2M).1  \nDeposits can also be localized to a single tissue such as in Alzheimer disease (Aβ in the brain), isolated atrial amyloidosis (AANF in cardiac atria), type 2 diabetes mellitus (AIAPP in the pancreas), and medullary thyroid cancer (ACal in the thyroid).1 While most hereditary forms of amyloidosis exhibit systemic involvement, some may be l","cbCaiiiSczHFKisp","https://ap.wps.com/l/cbCaiiiSczHFKisp","pdf",1120274,"English","# Introduction\n## Amyloidosis overview and ocular involvement\n## Diagnostic implications and biopsy findings\n# Case report\n## Patient history and presenting features\n## Surgical management and histopathology\n## Diagnostic work-up and interpretation","[{\"question\":\"What clinical presentation suggests secondary glaucoma due to intraocular amyloidosis?\",\"answer\":\"The case describes medically intractable elevations of intraocular pressure with an unremarkable anterior segment and significant vitreous opacities, which is a relatively uncommon presentation for this cause.\"},{\"question\":\"How was the type of amyloid determined in the report?\",\"answer\":\"Amyloid aggregates identified on histology were further characterized by mass spectrometric analysis, which revealed transthyretin-type amyloid (ATTR).\"},{\"question\":\"Why is a low threshold for biopsy recommended?\",\"answer\":\"When common ophthalmologic presentations fail to respond appropriately to standard therapies—especially with atypical exam findings—biopsy helps reveal acellular amyloid deposits and guides further work-up for systemic or hereditary associations.\"}]","Intraocular amyloidosis presenting with secondary glaucoma - a clinical-pathologic report and literature review | PDF",1790658268,13]