Biomicroscopic, gonioscopic and tomographic analysis of a Kayser-Fleischer ring: Case report

The Kayser- Fleischer Ring (KFR) is a characteristic, though not pathognomonic, feature of Wilson's disease (WD). It arises from copper deposition in Descemet's membrane and may exhibit a range of hues, including yellow-green, dull red, bright green, or blue. We report the case of a 58-year-old female patient in whom, in addition to copper deposition, optical coherence tomography (OCT) revealed leucomatous alterations in the corneal stroma adjacent to the deposit. Early recognition of this clinical sign plays a crucial role in the diagnosis of WD, in which timely identification is essential to reducing morbidity. In this study, we discuss the value of different diagnostic modalities for the detection and monitoring of this clinical sign and propose that copper toxicity may induce irreversible changes in the peripheral corneal stroma.