Secondary amyloidosis in the hydrops lesion of a patient with pellucid marginal degeneration.

PURPOSE: To report a case of secondary corneal amyloidosis in a chronic hydrops lesion of a patient with pellucid marginal degeneration (PMD).
METHODS: Clinicopathologic case report with a review of the literature. A 63-year-old man with PMD developed acute hydrops in 1999, which never resolved and became an elevated, gelatinous lesion with peripheral neovascularization. Penetrating keratoplasty was performed in 2005, and the excised button was examined histopathologically.
RESULTS: The excised button revealed substantial subepithelial acellular deposits consistent with amyloid in the area of the unresolved gelatinous lesion, overlying a disruption in Descemet membrane, confirming the diagnosis of secondary corneal amyloidosis.
CONCLUSIONS: Secondary corneal amyloidosis is a corneal response to chronic injury and irritation that is not commonly reported and often overlooked. To the best of our knowledge, this is the first report of a dramatic secondary amyloidosis deposit in the chronic hydrops lesion of a patient with PMD.