Abstract Listings 2024

Purpose

To describe three unique cases of periocular amyloidosis

Methods

Retrospective Case Series

Results

Three patients who presented with periocular amyloidosis between 2023 and 2024 were included. The first patient, a 54 year old female, presented with right upper eyelid ptosis and underwent ptosis repair with initial improvement but subsequent recurrence. Biopsy of the superior palpebral conjunctiva revealed amyloidosis and surgical debulking was performed. The second patient was a 45 year old male who was found to have infiltrative lesions of the tarsus in both upper eyelids and the left lower eyelid resulting in left lower eyelid tarsal ectropion. Biopsy revealed conjunctival amyloidosis extending to tarsus and a left lower eyelid ectropion repair was performed. The third patient, an 84 year old male, presented with a right corneal perforation requiring corneal gluing, likely due to exposure keratopathy as a result of right lacrimal gland enlargement and right upper and lower eyelid ectropion. After stabilization of the cornea, lacrimal gland biopsy revealed amyloidosis and debulking was performed with improvement in eyelid position. Histopathological examination was diagnostic in all cases. Two of the patients were lost to follow up so results of their systemic workup are not known. The first patient mentioned above had a negative systemic work up for amyloidosis and was found, 4 months after debulking, to have recurrence of the right upper eyelid lesion.

Conclusion

A rare finding, periocular amyloidosis may present in a variety of ways. In some cases, infiltration of tissue may be directly visualized. However, this diagnosis should also be considered in patients with eyelid malposition that present atypically or with recurrence after intervention. Our case series underscores the importance of considering amyloidosis in the differential diagnosis of eyelid and lacrimal gland pathology.

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