Asymmetric Deep Stromal Keratopathy in a Patient With Multiple Myeloma

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Abstract

Purpose:

To report a case of asymmetric deep stromal keratopathy in a patient with multiple myeloma.

Methods:

Case report and literature review.

Results:

An 85-year-old woman was found to have progressive visually significant left-sided deep stromal opacity in the setting of monoclonal gammopathy. Hematologic workup resulted in a diagnosis of IgG kappa multiple myeloma. Histopathology was significant for semicrystalline deposits in the posterior stroma. The patient's visual acuity improved to 20/50 7 months after penetrating keratoplasty. A similar deep stromal lesion appeared in the right eye 2 years after initial presentation.

Conclusions:

We present an unusual case of paraproteinemic keratopathy with a uniquely asymmetric presentation that resulted in a diagnosis of multiple myeloma.

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