Corneal immunoglobulin deposition in the posterior stroma. A case report including immunohistochemical and ultrastructural observations

Corneal buttons from a patient with bilateral, central, deeply located white corneal deposits that resembled the clinical description of filiform dystrophy were examined by means of light microscopy, immunohistochemistry, and electron microscopy. With light microscopy, the acidophilic fusiform deposits were seen to be oriented parallel to the stromal lamellae and were mostly in the pre-Descemet region. Immunohistochemical studies disclosed that the stromal lesions stained positively for IgG and lambda light chain. With electron microscopy, the immunoglobulin deposits within the deep corneal stroma appeared to be locally synthesized by the keratocytes. Recent examination of the patient's serum failed to disclose dysproteinemia.