PURPOSE: To report the clinical and histopathologic findings of the corneal deposits in a patient with monoclonal gammopathy. METHODS: Amorphous corneal deposits developed bilaterally in a 55-year-old woman. The corneal button obtained during penetrating keratoplasty was analyzed histologically, immunohistochemically, and ultrastructurally. RESULTS: The patient was diagnosed as having monoclonal gammopathy because of the elevation of serum immunoglobulin G (IgG) and kappa light chain. Histologic evaluation disclosed that the deposits were eosinophilic, periodic acid-Schiff positive, and stained red with Masson's trichrome. Immunohistochemical examination showed that these deposits reacted positively for IgG and the kappa light chain. Electron microscopy showed electron-dense deposits composed of parallel fine filaments with a periodicity of 10-13 nm. CONCLUSIONS: We conclude from the immunohistochemical results that monoclonal gammopathy can lead to corneal deposits that are dense enough to decrease vision. Because monoclonal gammopathy may be a life-threatening disease and early diagnosis is important, ophthalmologists should be aware that corneal deposits can be an alerting sign of monoclonal gammopathy.
PURPOSE: To report the clinical and histopathologic findings of the corneal deposits in a patient with monoclonal gammopathy. METHODS: Amorphous corneal deposits developed bilaterally in a 55-year-old woman. The corneal button obtained during penetrating keratoplasty was analyzed histologically, immunohistochemically, and ultrastructurally. RESULTS: The patient was diagnosed as having monoclonal gammopathy because of the elevation of serum immunoglobulin G (IgG) and kappa light chain. Histologic evaluation disclosed that the deposits were eosinophilic, periodic acid-Schiff positive, and stained red with Masson's trichrome. Immunohistochemical examination showed that these deposits reacted positively for IgG and the kappa light chain. Electron microscopy showed electron-dense deposits composed of parallel fine filaments with a periodicity of 10-13 nm. CONCLUSIONS: We conclude from the immunohistochemical results that monoclonal gammopathy can lead to corneal deposits that are dense enough to decrease vision. Because monoclonal gammopathy may be a life-threatening disease and early diagnosis is important, ophthalmologists should be aware that corneal deposits can be an alerting sign of monoclonal gammopathy.
Authors: Walter Lisch; Joanna Wasielica-Poslednik; Tero Kivelä; Ursula Schlötzer-Schrehardt; Jens M Rohrbach; Walter Sekundo; Uwe Pleyer; Christina Lisch; Alexander Desuki; Heidi Rossmann; Jayne S Weiss Journal: Trans Am Ophthalmol Soc Date: 2016-08
Authors: Johannes Steinberg; Mau-Thek Eddy; Toam Katz; Eike Matthiessen; Otto H Fricke; Gisbert Richard; Stephan J Linke Journal: Case Rep Ophthalmol Date: 2011-07-26