Clinical and histopathological features of a suspected case of fish-eye disease.

PURPOSE

To report the clinical and histopathological features of a suspected case of fish-eye disease.

CASE

A 57-year-old man presented with blurred vision. The best corrected visual acuity was 0.8 OD and 1.0 OS. The patient had no family history of cloudy cornea. Slit-lamp examination revealed massive bilateral diffuse corneal clouding. Because of progressive corneal clouding during the previous 3 years, we performed penetrating keratoplasty and cataract surgery. He had a low-plasma, high-density lipoprotein (HDL) concentration. Histopathologically, numerous small vacuoles were dispersed, especially in the anterior corneal stroma. An electron microscope revealed distinct 0.2-3.0-μm lipid vacuoles with a conserved stromal structure.

CONCLUSION

We suspected a case of sporadic fish-eye disease in a Japanese patient. Lipid deposition needs to be considered as a cause of diffuse corneal opacity.