Asymmetric Deep Stromal Keratopathy in a Patient With Multiple Myeloma

Cornea. 2017 Mar;36(3):372-374. doi: 10.1097/ICO.0000000000001139.

Abstract

Purpose: To report a case of asymmetric deep stromal keratopathy in a patient with multiple myeloma.

Methods: Case report and literature review.

Results: An 85-year-old woman was found to have progressive visually significant left-sided deep stromal opacity in the setting of monoclonal gammopathy. Hematologic workup resulted in a diagnosis of IgG kappa multiple myeloma. Histopathology was significant for semicrystalline deposits in the posterior stroma. The patient's visual acuity improved to 20/50 7 months after penetrating keratoplasty. A similar deep stromal lesion appeared in the right eye 2 years after initial presentation.

Conclusions: We present an unusual case of paraproteinemic keratopathy with a uniquely asymmetric presentation that resulted in a diagnosis of multiple myeloma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Corneal Opacity / diagnosis*
  • Corneal Opacity / surgery
  • Corneal Stroma / pathology*
  • Female
  • Humans
  • Immunoglobulin kappa-Chains / immunology
  • Keratoplasty, Penetrating
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / immunology
  • Paraproteinemias / diagnosis*
  • Paraproteinemias / immunology
  • Visual Acuity / physiology

Substances

  • Immunoglobulin kappa-Chains