Dados do Trabalho

Título

CONJUNCTIVAL AND PALPEBRAL AMYLOIDOSIS CAUSING BILATERAL ENTROPION: CASE REPORT

Introdução

Amyloidosis is a group of diseases where amyloid material is deposited in tissues. It can be classified as systemic or restricted to one organ, and subdivided into primary or secondary to chronic inflammatory disease. Primary conjunctival amyloidosis is a rare disease, typically unilateral, which clinically manifests as a pink or yellowish tumor, of variable size, painless, which can extend to the conjunctival sac, thereby altering the eyelid positioning. This case report describes a patient with a nodular lesion of the conjunctiva and bilateral lower eyelid that progressed to lower eyelid entropion and keratitis, whose surgical treatment with anatomopathological study revealed the diagnosis of amyloidosis.

Métodos

This is a retrospective, observational and descriptive study of a patient with conjunctive palpebral amyloidosis. Data were obtained through outpatient follow-up.

Resultados

Patient CDFR, female, 63 years old, reports hardening of the lower eyelid and continuous eye irritation with epiphora and red eye, which began 2 years ago and progressively worsens. The ophthalmological examination revealed bilateral lower eyelid entropion, thickening of the lower eyelid and the presence of a hard, yellowish pink lesion with an irregular surface, which extended from the tarsal conjunctiva to the lower conjunctival fornix. Visual acuity with 20/20 correction in both eyes. Clear cornea with inferior superficial keratitis due to entropion, lens with mild sclerosis, formed anterior chamber and photo-reactive pupil. Normal fundoscopy in both eyes. Surgery was performed to resect the conjunctival lesions and correct the entropion with refixation of the lower eyelid retractor elements, creation of a tarsal strip with improvement of the horizontal eyelid tension and mini lower blepharoplasty. It progressed with improvement in corneal irritation symptoms, correction of entropion with good position of the eyelid margin. The biopsy confirmed the diagnosis of amyloidosis, through Congo red staining. Despite the impossibility of resection of all conjunctival lesions, the patient presented restoration of eyelid function and prevention of ocular damage.

Conclusões

Although ophthalmological involvement is uncommon in amyloidosis, it is necessary to pay attention to this diagnosis so that correct monitoring and investigation of possible systemic involvement can be carried out.

Palavras Chave

Amyloidosis; Conjunctiva; Entropion.

Arquivos

Área

DOENÇAS EXTERNAS OCULARES E CÓRNEA