The usefulness of corneal confocal microscopy to assessing and monitoring changes associated with hematopoietic diseases

Abstract

AbstractPurpose Evaluation of corneal confocal microscopy in vivo to assess and monitor changes in the course of hematopoietic proliferative diseases.Methods In 3 patients (2 males and 1 female) examined because of suspicion of an unknown keratopathy we performed the following: basic slit lamp examination, corneal scans using Scheimpflug camera (Pentacam, Oculus) and corneal confocal microscopy in vivo (Rostock Cornea module, Heidelberg Engineering Retina tomograph III). All patients were sent to hematology consult.Results On a slit lamp examination we described macroscopic, polymorphic deposits of crystals, located in the full thickness of corneal stroma. In the image from Scheimpflug camera ‐ diffusive crystals causing increased hyperreflexive stroma. The corneal confocal microscopy images showed polymorphic crystalline deposits within the corneal stroma reaching the level of the endothelium from Bowmann membrane. After exclusion of hypercholesterolemia and cystinosis, patients were referred to the hematology consultation, where the following hematopoietic diseases were diagnosed: multiple myeloma, monoclonal gammopathy, light chain disease.Conclusion Corneal confocal microscopy is a useful tool for the detection and differentiation of the etiology of crystalline keratopathy. Performed at the appropriate stage can help in the early detection of disorders of the hematopoietic system.