A case of monoclonal gammopathy with corneal stroma deposits

BACKGROUND: Monoclonal gammopathy is a group of disorders characterized by proliferation of a single clone of plasma cells that produce monoclonal protein. Sometimes benign monoclonal gammopathy that is a symptomatic can turn into a malignancy like multiple myeloma. We present a case of monoclonal gammopathy with corneal deposits which was treated with deep lamellar keratoplasty (DLKP). The corneal button obtained at the time of DLKP was studied with both light and electron microscopy. CASE: Fine corneal deposits developed bilaterally in a 69-year-old man. There was no family history of ocular diease. RESULTS: We diagnosed monoclonal gammopathy in a blood test that showed elevation of serum immunoglobulin G and the Kappa chain. The corneal button obtained during DLKP was analyzed histologically and ultrastructurally. Electron microscopy showed electron-dense deposits composed of fine parallel filaments in the corneal epithelium and stroma. CONCLUSIONS: Corneal deposits of unknown origin might turn into monoclonal gammopathy that could be a life-threatening disease. It is important for ophthalmologists to check the whole body of a patient when finding corneal deposits.