Ocular manifestations of transthyretin amyloidosis and their diagnostic value in cardiology: A comprehensive review

BACKGROUND: Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF); however, early diagnosis remains challenging. OBJECTIVE: From the perspective of cardiovascular physicians, this review systematically elucidates the ocular manifestations of ATTR, explores their clinical significance as early diagnostic clues, and proposes an integrated diagnostic pathway incorporating ophthalmologic assessment. CONTENT: This article focuses on the pathophysiological mechanisms and recognition criteria of characteristic ocular signs, including vitreous amyloidosis and secondary glaucoma, and constructs a multidisciplinary diagnostic workflow integrating cardiac imaging, ophthalmologic "red flags," and molecular diagnostic techniques. CONCLUSIONS: Incorporating ocular manifestations into routine cardiovascular history-taking and systematic evaluation holds significant clinical value for improving early ATTR-CM diagnosis rates and patient outcomes. Active promotion of cardiovascular-ophthalmology-neurology multidisciplinary collaboration is warranted.