title: Corneal Structural Changes in Nonneoplastic and Neoplastic Monoclonal Gammopathies.
abstract: To investigate corneal confocal microscopic changes in nonneoplastic and neoplastic monoclonal gammopathies.
  
  
  
  Three groups of subjects were considered: group 1, twenty normal subjects; group 2, fifteen patients with monoclonal gammopathy of undetermined significance (MGUS); group 3, eight patients with smoldering multiple myeloma and eight patients with untreated multiple myeloma. After hematologic diagnosis, patients underwent ophthalmologic exam and in vivo confocal microscopic study. The statistical analysis was performed using ANOVA and Student-Newman-Keuls tests and receiver operating characteristic (ROC) curve analysis.
  
  
  
  Epithelial cells of gammopathic patients showed significantly higher reflectivity than controls, demonstrated by optical density (P < 0.001). Subbasal nerve density, branching, and beading were significantly altered in gammopathic patients (P = 0.01, P = 0.02, P = 0.02, respectively). The number of keratocytes was significantly reduced in neoplastic patients (P < 0.001 versus both normal and MGUS) in the anterior, medium, and posterior stroma. The ROC curve analysis showed good sensitivity and specificity for this parameter. Group 2 and 3 keratocytes showed higher nuclear and cytoplasmatic reflectivity in the medium and posterior stroma. Endothelial cells were not affected.
  
  
  
  Patients with neoplastic gammopathies showed peculiar alterations of the keratocyte number, which appeared significantly reduced. A follow-up with corneal confocal microscopy of patients with MGUS is suggested as a useful tool to identify peripheral tissue alterations linked to possible neoplastic disease development.
authors.affiliation: Department of Biomedical Sciences Regional Referral Center for the Ocular Surface Diseases, University of Messina, Messina, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Aragona
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Allegra
authors.affiliation: Department of Biomedical Sciences Regional Referral Center for the Ocular Surface Diseases, University of Messina, Messina, Italy.
authors.forename: Elisa Imelde
authors.initials: EI
authors.lastname: Postorino
authors.affiliation: Department of Biomedical Sciences Regional Referral Center for the Ocular Surface Diseases, University of Messina, Messina, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Rania
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Innao
authors.affiliation: Department of Ophthalmology, District Railway Hospital, Katowice, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Wylegala
authors.affiliation: Department of Ophthalmology, District Railway Hospital, Katowice, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Nowinska
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ieni
authors.affiliation: Department of Biomedical Sciences, University of Messina, Messina, Italy.
authors.forename: Antonina
authors.initials: A
authors.lastname: Pisani
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Musolino
authors.affiliation: Department of Biomedical Sciences, University of Messina, Messina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Puzzolo
authors.affiliation: Department of Biomedical Sciences, University of Messina, Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Micali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology; D060527:Corneal Keratocytes / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology*; D003430:Cross-Sectional Studies; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications* / Q000175:diagnosis