Localised conjunctival AL-amyloid deposits secondary to a retinal detachment surgery radial explant

Retin Cases Brief Rep. 2020 Nov 17. doi: 10.1097/ICB.0000000000001088. Online ahead of print.

Abstract

Purpose: To describe a hitherto unreported late ocular surface complication of retinal detachment surgery around a radial segment explant.

Methods: A single case report of a 72 year-old white Caucasian male, with a previous history of right scleral buckling surgery for retinal detachment surgery 25 years ago, presented with right-sided ptosis of 6 months duration.

Results: Ocular surface examination showed a prominent right supero-nasal quadrant radial segment explant, around which there was bulky pink conjunctival mass, extending from the supero-medial fornix down to the medial canthal area and inferior medial fornix with similar changes seen on the upper medial tarsal conjunctiva. The clinical differential diagnosis was either inflammation from an exposed radial explant or lymphoma. Biopsies of the conjunctival mass showed perivascular and interstitial solid eosinophilic deposits of amyloid, with scattered giant cells; the amyloid was of AL type. There was no morphological or immunohistochemical evidence of lymphoma or a plasma cell neoplasm in the specimen.

Conclusion: This is the first report of localised conjunctival amyloid deposition, secondary to a retinal detachment radial explant. It is proposed that the localised amyloid deposit arose from the ocular surface irritative effects of the radial explant.