Paladini Iacopo, Pieretti Giulia, Giuntoli Matteo, Abbruzzese Giacomo, Menchini Ugo, Mencucci Rita
Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, University of Florence, Policlinic of Careggi, Florence, Italy.
Semin Ophthalmol. 2013 Jan;28(1):37-40. doi: 10.3109/08820538.2012.730102.
To describe the in-vivo confocal microscopy corneal findings in a patient with bilateral corneal deposits caused by an underlying monoclonal gammopathy.
A 68-year-old man came to our center for an ophthalmologic examination. Besides visual acuity, the examination included slit-lamp biomicroscopy, intraocular pressure, and fundoscopy. Confocal microscopy was performed using Confoscan 4 (Nidek Technologies Padova, Italy) with a 40× lens because of the presence of bilateral crystalline corneal deposits. Serological tests were also performed.
Every layer of the cornea is interested by deposits with high reflectivity,especially the epithelium and anterior stroma. The emathological tests evidenced a monoclonal gammopathy of undetermined significance with high levels of Immunoglobulin M.
Crystalline corneal deposits in monoclonal gammopathycan be usefully evaluated by confocal microscopy. These manifestations may be evaluated long before systemic signs of the pathology appear, so the early diagnosis is mandatory.
描述一名潜在单克隆丙种球蛋白病导致双侧角膜沉积物患者的共聚焦显微镜下角膜表现。
一名68岁男性到我们中心进行眼科检查。检查除视力外，还包括裂隙灯生物显微镜检查、眼压测量和眼底检查。由于存在双侧结晶性角膜沉积物，使用配备40倍镜头的Confoscan 4（意大利帕多瓦尼德克技术公司）进行共聚焦显微镜检查。还进行了血清学检查。
角膜各层均有高反射性沉积物，尤其是上皮层和前基质层。血液学检查显示存在意义未明的单克隆丙种球蛋白病，免疫球蛋白M水平升高。
共聚焦显微镜可有效评估单克隆丙种球蛋白病中的结晶性角膜沉积物。这些表现可能早在该疾病的全身症状出现之前就可被评估，因此早期诊断至关重要。
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