Ocular findings in patients with acquired ATTRv amyloidosis following domino liver transplantation

PLoS One. 2023 Sep 15;18(9):e0291716. doi: 10.1371/journal.pone.0291716. eCollection 2023.

Abstract

Purpose: To investigate the presence of amyloidosis-related ocular findings in patients who received domino liver transplantation from ATTRv amyloidosis donors.

Methods: We reviewed the ocular findings in patients who had previously undergone domino liver transplantation and received ophthalmologic examinations between January 2009 and March 2023. The presence of amyloidosis-related ocular findings was retrospectively assessed by two ophthalmologists.

Results: During the study period, a total of 7 patients with 14 eyes were examined. All patients were considered as acquired ATTRv amyloidosis. The mean age at the final visit was 64.6±8.4 years (52-75 years), and the mean time since domino liver transplantation was 167.6±76.2 months (69-257 months). The two evaluators' assessments for amyloidosis-related ocular findings were completely identical. No amyloid fibril deposition was observed in the pupil, lens, or vitreous. Five patients (10 eyes) had a Schirmer test result of 5mm or less than 5 mm, and four patients with a total of 8 eyes underwent fluorescein angiography and indocyanine green angiography, and no evidence of retinal amyloid angiopathy was found on fluorescein angiography. However, three patients with 6 eyes showed choroidal amyloid angiopathy on indocyanine green angiography.

Conclusion: While cases of choroidal amyloid angiopathy were observed, serious amyloidosis-related ocular complications such as vitreous opacity or secondary glaucoma did not occur even in the long term after domino liver transplantation.

MeSH terms

  • Aged
  • Amyloidosis*
  • Cerebral Amyloid Angiopathy
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green*
  • Middle Aged
  • Pupil
  • Retrospective Studies

Substances

  • Indocyanine Green

Supplementary concepts

  • Amyloid angiopathy