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Published on: February 8, 2019
Histopathologic examination of conjunctival tophi in gouty arthritis
Wayne R Lo1, Geoffrey Broocker, Hans E Grossniklaus
1Department of Ophthalmology, Emory University School of Medicine, and Emory Eye Center, 1365B Clifton Road NE, Atlanta, GA 30322, USA.
Purpose:
To report a case of conjunctival tophi in a 59-year-old woman with gouty arthritis.
Design:
Observational case report.
Methods:
A 59-year-old woman with a 25-year history of severe gouty arthritis presented with bilateral chalky white conjunctival deposits. Conjunctival biopsies were obtained, and light and electron microscopy studies were performed.
Results:
Light microscopy confirmed multiple gouty tophi. Transmission electron microscopy revealed intracytoplasmic crystalline deposits within histiocytes. Extracellular aggregates of the crystalline deposits were enclosed by membranous material.
Conclusions:
Conjunctival crystals may aid in identifying undiagnosed patients. In addition to conjunctival tophi, patients may also have uveitis, corneal crystals, and band keratopathy.
