Ocular manifestations in systemic amyloidosis

Abstract

Objective: To describe a case of AL amyloidosis with ocular involvement, analyzing its clinical manifestations, complementary exams, and therapeutic management. Case report: A 52-year-old female patient with a previous diagnosis of AL amyloidosis who was undergoing chemotherapy presented with progressive low visual acuity and epiphora for one year and nine months. She reported worsening of symptoms, accompanied by eyelid edema, macroglossia, and dyspnea. The examination revealed bilateral restricted ocular mobility (“frozen stare”), in addition to periorbital edema and hematoma in the right eye. Computed tomography revealed thickening of the bilateral retroorbital muscles. Laboratory tests indicated increased proteinuria and the presence of lambda light chains in urinary immunofixation. The patient received multidisciplinary follow-up, including clinical support and therapeutic adjustments for symptom management. Final considerations: Ocular involvement in AL amyloidosis is a relevant manifestation, which may compromise visual function and quality of life of patients. Early identification and multidisciplinary follow-up are essential for symptom control and prevention of complications. This case highlights the importance of detailed ophthalmologic evaluation and appropriate management of amyloidosis, emphasizing the need for greater awareness of its systemic and ophthalmologic manifestations.