Characterization of corneal deposition keratopathy in the setting of blood cell dyscrasia and a minimally invasive technique to clear the cornea in a single case

Hillary C. Stiefel, Rasanamar K. Sandhu, Audra K. Miller, David Wilson, Winston Chamberlain

Research output: Contribution to journalArticle

Abstract

Purpose: To report 3 cases of corneal protein deposition occurring in association with systemic disease, with one case demonstrating a novel technique for clearing corneal deposits. Observations: Three patients presented with corneal deposits associated with systemic disease. Corneal involvement was noted prior to diagnosis of systemic disease in two patients, leading to subsequent diagnosis of multiple myeloma or monoclonal gammopathy of undetermined significance. OCT revealed protein deposition at various corneal levels, including at different stromal depths in the two cases of multiple myeloma. A novel technique of posterior endothelial scraping was performed in one case with deep stromal deposits, leading to significant corneal clearing. Conclusions and Importance: This case series demonstrates that recognition of corneal deposits may precede the diagnosis of systemic disease. It incorporates the use of anterior segment OCT to characterize corneal deposits, and demonstrates a novel surgical technique for clearing certain types corneal deposits.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalAmerican Journal of Ophthalmology Case Reports
Volume13
DOIs
StatePublished - Mar 1 2019

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Cornea
Blood Cells
Multiple Myeloma
Monoclonal Gammopathy of Undetermined Significance
Proteins

Keywords

  • Anterior segment optical coherence tomography
  • Corneal pathology
  • Crystalline keratopathy
  • Deposition keratopathy
  • Multiple myeloma
  • Paraproteinemia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "Characterization of corneal deposition keratopathy in the setting of blood cell dyscrasia and a minimally invasive technique to clear the cornea in a single case",
abstract = "Purpose: To report 3 cases of corneal protein deposition occurring in association with systemic disease, with one case demonstrating a novel technique for clearing corneal deposits. Observations: Three patients presented with corneal deposits associated with systemic disease. Corneal involvement was noted prior to diagnosis of systemic disease in two patients, leading to subsequent diagnosis of multiple myeloma or monoclonal gammopathy of undetermined significance. OCT revealed protein deposition at various corneal levels, including at different stromal depths in the two cases of multiple myeloma. A novel technique of posterior endothelial scraping was performed in one case with deep stromal deposits, leading to significant corneal clearing. Conclusions and Importance: This case series demonstrates that recognition of corneal deposits may precede the diagnosis of systemic disease. It incorporates the use of anterior segment OCT to characterize corneal deposits, and demonstrates a novel surgical technique for clearing certain types corneal deposits.",
keywords = "Anterior segment optical coherence tomography, Corneal pathology, Crystalline keratopathy, Deposition keratopathy, Multiple myeloma, Paraproteinemia",
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T1 - Characterization of corneal deposition keratopathy in the setting of blood cell dyscrasia and a minimally invasive technique to clear the cornea in a single case

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AU - Sandhu, Rasanamar K.

AU - Miller, Audra K.

AU - Wilson, David

AU - Chamberlain, Winston

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AB - Purpose: To report 3 cases of corneal protein deposition occurring in association with systemic disease, with one case demonstrating a novel technique for clearing corneal deposits. Observations: Three patients presented with corneal deposits associated with systemic disease. Corneal involvement was noted prior to diagnosis of systemic disease in two patients, leading to subsequent diagnosis of multiple myeloma or monoclonal gammopathy of undetermined significance. OCT revealed protein deposition at various corneal levels, including at different stromal depths in the two cases of multiple myeloma. A novel technique of posterior endothelial scraping was performed in one case with deep stromal deposits, leading to significant corneal clearing. Conclusions and Importance: This case series demonstrates that recognition of corneal deposits may precede the diagnosis of systemic disease. It incorporates the use of anterior segment OCT to characterize corneal deposits, and demonstrates a novel surgical technique for clearing certain types corneal deposits.

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KW - Deposition keratopathy

KW - Multiple myeloma

KW - Paraproteinemia

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