Primary Localized Conjunctival Amyloidosis-A Case Report

Purpose: To report a case of primary localized conjunctival amyloidosis. The clinical features, pathological findings, and surgical outcomes were described. Method: Case Report. Results: A 66-year-old man presented with progressive growing mass lesions of bilateral conjunctiva noted for three years. He underwent bilateral surgical excision of the lesions in USA two years ago and conjunctival amyloidosis was diagnosed. The mass lesions recurred soon after the surgery and he suffered from grittiness and foreign body sensation of both eyes. His best-corrected visual acuity on examination was 6/6 OU. Yellow nodular gelatinous lesions were noted in bilateral nasal bulbar conjunctiva. Incisional biopsy of the right eye lesions revealed amyloid deposits, which stained positively with antibody to human kappa and lambda immunoglobulin light chains. A systemic survey showed neither evidences of multiple myeloma, nor involvement of other organs. Surgical debulking of the left eye lesions plus reconstruction with amniotic membrane was then performed. Recurrence of amyloid deposition was noted in both eyes less than one month after surgery. Conclusion: Primary localized conjunctival amyloidosis is usually not associated with systemic diseases. For symptomatic cases, conservative treatment with lubricants is suggested initially. Palliative debulking instead of extensive excision is considered for more advanced cases, because the amyloid deposits tend to recur soon after surgery.