Open AccessIn vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases
Author(s) -
Sibel Kocabeyoğlu,
Mehmet Cem Mocan,
İbrahim C. Haznedaroğlu,
Ayşegül Üner,
Enes Uzunosmanoglu,
Murat İrkeç
Publication year - 2014
Publication title -
indian journal of ophthalmology/indian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 51
eISSN - 1998-3689
pISSN - 0301-4738
DOI - 10.4103/0301-4738.143933
Subject(s) - medicine , monoclonal gammopathy of undetermined significance , multiple myeloma , pathology , stroma , biopsy , monoclonal gammopathy , monoclonal , stromal cell , corneal epithelium , bone marrow , dermatology , monoclonal antibody , immunohistochemistry , epithelium , antibody , immunology
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.