title: Crystalline corneal deposits in monoclonal gammopathy: in-vivo confocal microscopy.
abstract: OBJECTIVE
  To describe the in-vivo confocal microscopy corneal findings in a patient with bilateral corneal deposits caused by an underlying monoclonal gammopathy.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, University of Florence, Policlinic of Careggi, Florence, Italy. lapopala@hotmail.com
authors.forename: Iacopo
authors.initials: I
authors.lastname: Paladini
authors.forename: Giulia
authors.initials: G
authors.lastname: Pieretti
authors.forename: Matteo
authors.initials: M
authors.lastname: Giuntoli
authors.forename: Giacomo
authors.initials: G
authors.lastname: Abbruzzese
authors.forename: Ugo
authors.initials: U
authors.lastname: Menchini
authors.forename: Rita
authors.initials: R
authors.lastname: Mencucci
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D010265:Paraproteinemias / Q000150:complications*