Ocular crystal deposition leading to a diagnosis of multiple myeloma: a report of 2 cases and review of the literature

Abstract

Corneal crystal deposition due to multiple myeloma is a rare ocular manifestation caused by elevated

Paraproteinemic keratopathy: recognizing the ocular significance

“…Although an uncommon presentation, paraproteinemic keratopathy, originally called immunotactoid keratopathy, 1 may be the first manifestation. 2,3 Patients may present with photophobia, glare, and decreased visual acuity or remain asymptomatic with crystals and opacities detected incidentally. Optimal treatment is not yet established, but chemotherapy, superficial keratectomy, and penetrating keratoplasty (PKP) have been reported.…”

“…2À4 We present 3 cases of paraproteinemic keratopathy and provide follow-up on 2 patients, documenting the potential for long-term success of treatment. 3 The first case is a 65-year-old female with blurred vision who was noted to have superficial refractile corneal crystals 2 months after cataract extraction with lens implantation. Her best corrected visual acuity (BCVA) in both eyes was 20/50.…”

“…The fourth case is a previously reported 53-year-old female with numerous bilateral iridescent whorl-like crystals in the corneal subepithelium and anterior stroma. 3 She was diagnosed with multiple myeloma with IgG kappa monoclonal protein and 3 years later developed mild anemia. Treatment with bortezomib and dexamethasone followed by high-dose melphalan and ASCT completely resolved the crystals.…”

“…The fifth case is a previously reported 50-year-old female with bilateral crystal formation at the flap interface after LASIK surgery. 3 Operative lifting of the flap and scraping of the crystals improved visual acuity, but crystals continued to accumulate. Work-up revealed an IgG kappa monoclonal gammopathy and kappa light-chain proteinuria and possible myeloma.…”