Secondary corneal amyloidosis in keratoconus

Area of Science:

• Ophthalmology
• Corneal Diseases
• Histopathology

Background:

• Keratoconus is a progressive thinning disorder of the cornea.
• Long-term hard contact lens wear is a known risk factor for various corneal complications.
• Amyloid deposition can occur in various tissues, but its presence in keratoconus is rare.

Observation:

• A 37-year-old male with a history of keratoconus and prolonged hard contact lens use underwent penetrating keratoplasty.
• Histological examination of the excised corneal button revealed characteristic amyloid deposits.
• These deposits exhibited Congo red staining and apple-green birefringence under polarized light microscopy.

Findings:

• The corneal amyloid deposition was inferred to be secondary to the underlying keratoconus.
• No other systemic or ocular pathologies were identified to explain the amyloidosis.
• This case highlights a potential, previously under-recognized association between keratoconus and secondary corneal amyloidosis.

Implications:

• Understanding the etiopathogenesis of amyloid deposition in keratoconus may lead to novel diagnostic or therapeutic strategies.
• Further research is warranted to explore the mechanisms linking keratoconus and amyloid formation.
• This case contributes to the literature on rare corneal pathologies and their association with underlying structural abnormalities.