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January 1980, Vol 98, No. 1 >
ARTICLE | January 1980

Unusual Superficial Stromal Corneal Deposits in IgG κ Monoclonal Gammopathy FREE

Richard A. Eiferman, MD; Merlyn M. Rodrigues, MD, PhD
[+] Author Affiliations

Accepted for publication April 9, 1979.

Reprint requests to University of Louisville, 301 E Walnut St, Louisville, KY 40202 (Dr Eiferman).


Arch Ophthalmol. 1980;98(1):78-81. doi:10.1001/archopht.1980.01020030080003
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References
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• Unusual corneal stromal deposits at the level of Bowman's membrane and superficial stroma were associated with severe photophobia and tearing as the initial signs of an IgG κ monoclonal gammopathy. A corneal biopsy specimen showed superficial stroma areas that stained red with Masson trichrome stain. These deposits were positive for IgG and κ chains. Histopathologic examination revealed focal disruption in Bowman's membrane with extension into the epithelium. Electron microscopy of the deposits disclosed parallel linear profiles compatible with immunoglobulin.

REFERENCES

1 +
Klintworth GK, Bredeheuft SJ, Reed JW:  Analysis of corneal crystalline deposits in multiple myeloma . Am J Ophthalmol 86:303-313, 1978;.
2 +
Ritzmann SE, Loukas D, Sakai H, et al:  Idiopathic (asymptomatic) monoclonal gammopathies . Arch Intern Med 135:95-105, 1975;.
3 +
Bürki E:  Über Hornhautveränderungen bein einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 135:565-572, 1958;.
4 +
Meesman A:  Über eine eigenartige Hornhautdegeneration . Ber Zusammenkunft Dtsch Ophthalmol Ges 50:311-315, 1934;.
5 +
Markoff N:  Ueber Kristallbildung in der Hornhaut bei Urethan-therapie de Myelom . Schweiz Med Wochenschr 78:987-988, 1948;.
6 +
Horacek J:  Kristallinische Augendengeneration als erstes Anzeichen des plasmozytarenloms . Zentralbl Allg Pathol 104:264-267, 1963;.
7 +
Palazon GA:  Depot de cristaux dans la cornée . Ann Hosp Jose Y Adela 4:235-236, 1933;.
8 +
Blobner F:  Kristallinische Degeneration der Bindehaut und Hornhaut . Klin Monatsbl Augenheilkd 100:588-593, 1938;.
9 +
Plam E:  A case of crystal deposits in the cornea: Precipitation of a spontaneously crystallizing plasma globulin . Acta Ophthalmol 25:165-174, 1947;.
10 +
Bürki E:  Über Hornhautveränderungen bein einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 135:565-572, 1958;.
11 +
Aronson SB, Shaw R:  Corneal crystals in multiple myeloma . Arch Ophthalmol 61:541-552, 1959;.
12 +
Laibson PR, Damiano VV:  X-ray and electron diffraction of ocular and bone marrow crystals in paraproteinemia . Science 163:581-583, 1969;.
13 +
Pinkerton RMH, Robertson DM:  Corneal and conjunctival changes in dysproteinemia . Invest Ophthalmol Vis Sci 8:357-364, 1969;.
14 +
Francois J:  Paraproteinaemic thesaurismosis of the cornea in Kahler's multiple myelomatosis . Ear Nose Throat J 46:857-867, 1967;.
15 +
Ito S, Goshima K, Ninomi M, et al:  Electron microscopic studies of the crystalline inclusions in the myeloma cells and kidney of K-Bence-Jones protein type myeloma . Acta Hematol Jap 33:508-517, 1970;.
16 +
Zlotnick A, Rosenmann E:  Renal pathologic findings associated with monoclonal gammopathies . Arch Intern Med 135:40-45, 1975;.
17 +
Rodrigues MM, Krachmer JH, Miller SD, et al:  Posterior corneal crystalline deposits in benign monoclonal gammopathy: A clinicopathologic case report . Arch Ophthalmol 97:124-128, 1979;.
18 +
Allansmith MR, McClellan BH:  Immunoglobulins in the human cornea . Am J Ophthalmol 80:123-132, 1975;.
19 +
Allansmith M, Whitney C, McClellan B, et al:  Immunoglobulins in the human eye . Arch Ophthalmol 89:36-45, 1973;.
20 +
Rodrigues MM, Fine B, Laibson P, et al:  Disorders of the corneal epithelium: A clinicopathologic study of dot, geographic, and fingerprint patterns . Arch Ophthalmol 92:475-482, 1974;.

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1 +
Klintworth GK, Bredeheuft SJ, Reed JW:  Analysis of corneal crystalline deposits in multiple myeloma . Am J Ophthalmol 86:303-313, 1978;.
2 +
Ritzmann SE, Loukas D, Sakai H, et al:  Idiopathic (asymptomatic) monoclonal gammopathies . Arch Intern Med 135:95-105, 1975;.
3 +
Bürki E:  Über Hornhautveränderungen bein einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 135:565-572, 1958;.
4 +
Meesman A:  Über eine eigenartige Hornhautdegeneration . Ber Zusammenkunft Dtsch Ophthalmol Ges 50:311-315, 1934;.
5 +
Markoff N:  Ueber Kristallbildung in der Hornhaut bei Urethan-therapie de Myelom . Schweiz Med Wochenschr 78:987-988, 1948;.
6 +
Horacek J:  Kristallinische Augendengeneration als erstes Anzeichen des plasmozytarenloms . Zentralbl Allg Pathol 104:264-267, 1963;.
7 +
Palazon GA:  Depot de cristaux dans la cornée . Ann Hosp Jose Y Adela 4:235-236, 1933;.
8 +
Blobner F:  Kristallinische Degeneration der Bindehaut und Hornhaut . Klin Monatsbl Augenheilkd 100:588-593, 1938;.
9 +
Plam E:  A case of crystal deposits in the cornea: Precipitation of a spontaneously crystallizing plasma globulin . Acta Ophthalmol 25:165-174, 1947;.
10 +
Bürki E:  Über Hornhautveränderungen bein einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 135:565-572, 1958;.
11 +
Aronson SB, Shaw R:  Corneal crystals in multiple myeloma . Arch Ophthalmol 61:541-552, 1959;.
12 +
Laibson PR, Damiano VV:  X-ray and electron diffraction of ocular and bone marrow crystals in paraproteinemia . Science 163:581-583, 1969;.
13 +
Pinkerton RMH, Robertson DM:  Corneal and conjunctival changes in dysproteinemia . Invest Ophthalmol Vis Sci 8:357-364, 1969;.
14 +
Francois J:  Paraproteinaemic thesaurismosis of the cornea in Kahler's multiple myelomatosis . Ear Nose Throat J 46:857-867, 1967;.
15 +
Ito S, Goshima K, Ninomi M, et al:  Electron microscopic studies of the crystalline inclusions in the myeloma cells and kidney of K-Bence-Jones protein type myeloma . Acta Hematol Jap 33:508-517, 1970;.
16 +
Zlotnick A, Rosenmann E:  Renal pathologic findings associated with monoclonal gammopathies . Arch Intern Med 135:40-45, 1975;.
17 +
Rodrigues MM, Krachmer JH, Miller SD, et al:  Posterior corneal crystalline deposits in benign monoclonal gammopathy: A clinicopathologic case report . Arch Ophthalmol 97:124-128, 1979;.
18 +
Allansmith MR, McClellan BH:  Immunoglobulins in the human cornea . Am J Ophthalmol 80:123-132, 1975;.
19 +
Allansmith M, Whitney C, McClellan B, et al:  Immunoglobulins in the human eye . Arch Ophthalmol 89:36-45, 1973;.
20 +
Rodrigues MM, Fine B, Laibson P, et al:  Disorders of the corneal epithelium: A clinicopathologic study of dot, geographic, and fingerprint patterns . Arch Ophthalmol 92:475-482, 1974;.

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