In vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases.
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Date
2014-09
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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.
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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.