Amyloidosis of the vitreous body is a rare disorder that causes progressive visual loss. In this report, a 36-yr-old female with familial amyloidosis is described in whom a progressive reduction of vision in both eyes over the last 4 yr was ascribed to vitreous opacities due to amyloid. A left pars plana vitrectomy was performed and an aspirated sample of the vitreous on cytologic examination showed vitreous strands admixed with abundant dense, pink, globular material which was intensely positive on Congo red staining and exhibited yellowish-green birefringence indicative of amyloid. This was further confirmed ultrastructurally, which showed the classical appearance of amyloid fibrils. The case is of interest not only in view of the rarity of the condition but also in view of the fact that as far as we are aware the cytodiagnosis of amyloid from an aspirate sample from the vitreous has not been previously described in the literature.

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1In a recent communication from this laboratory, we reported on the cytodiagnosis of amyloid from an aspiration sample of the vitreous in a 36-year-old female with a history of familial amyloidosis in whom a left pars plana vitrectomy was done. The patient is now 38 years old, and for the last few months has had progressive deterioration of the vision in the right side. On examination, extensive opacification of the vitreous was found with a visual acuity of 6/18. The vision in the left side, however, has remained well and is 6/5 unaided. The right retina was difficult to visualize due to dense opacities. To improve the vision, a right-sided pars plana vitrectomy was performed. The intraoperative findings showed dense vitreous opacities, posterior vitreous detachment, and clumps of sheet-like and fibrillar opacities on posterior vitreous surface, and fluffy cotton wool-like opacities arising from retinal vessels. An aspirate sample of vitreous was obtained and collected directly in a cytology container in which 30% ethyl alcohol in physiologic saline was present. From half of the material, filter preparations were made on size 3 micron Schleicher and Schuell membrane filters and stained by Papanicolaou method while the remainder of the sample was spun and from sediment a cell block was made; sections were cut and stained with hematoxylin-eosin and Congo red stain. For electronmicroscopy (EM), a portion of cell block was divided into 1 mm cubes, fixed in glutaraldehyde, postfixed in osmium tetroxide, passed through graded alcohols, embedded, sectioned, and stained with uranyl acetate and lead citrate.Papanicolaou-stained filter preparations and hematoxylin-eosin-stained sections of cell blocks showed abundant amorphous, dense pink globular excrescences indic-