In vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases.

Abstract
In this paper, we report two cases of a 62‑year‑old patient presented with blurred vision and a 45‑year‑old male diagnosed with multiple myeloma who was referred from the Department of Oncology. Slit‑lamp examination, in vivo confocal microscopy (IVCM), systemic work‑up and serum protein electrophoresis were obtained. In both patients, slit‑lamp findings revealed bilateral diffuse subepithelial and anterior stromal crystals and IVCM showed highly reflective deposits in the corneal epithelium and stroma. The first patient was eventually diagnosed with monoclonal gammopathy of undetermined significance following bone marrow biopsy and systemic evaluation. Unusual corneal deposits may constitute the first sign of monoclonal gammopathies. IVCM may be helpful in showing the crystalline nature of the corneal deposits and guiding the clinician to the diagnosis of gammopathies. Both ophthalmologists and oncologists should be aware that corneal deposits may herald a life‑threatening hematologic disease.
Description
Keywords
Corneal deposits, in vivo confocal microscopy, monoclonal gammopathy of undetermined significance, multiple myeloma
Citation
Kocabeyoglu Sibel, Mocan Mehmet C, Haznedaroglu Ibrahim C, Uner Aysegul, Uzunosmanoglu Enes, Irkec Murat. In vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases. Indian Journal of Ophthalmology. 2014 Sept ; 62 (9): 938-940.