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[Crystalline keratopathy as a presenting sign of multiple myeloma]
Background:
Noninfectious crystalline corneal degenerations can be classified from the clinical and genetical point of view into 3 groups: 1. primary hereditary (Schnyder), 2. secondary hereditary (cystinosis) and 3. secondary non-hereditary in association with disorders of serum protein or lipid composition.
Patient:
We report on a 63-year-old man with reduced vision and grey-white, crystalline, monomorpheous deposits in the corneal stroma. Further investigation revealed IgG myeloma.
Results:
We performed a penetrating keratoplasty for visual improvement. On histopathological examination, typical eosinophilic, PAS-positive, interlamellar deposits staining brilliant red with Masson's trichrome were found diffusely scattered throughout the stroma. Electron microscopy showed intracellular, rhomboid-shaped deposits enveloped by a membrane.
Conclusion:
The appearance of a crystalline keratopathy should be followed by an internal examination for early detection and adequate treatment of a systemic disease.