title: Asymmetric Deep Stromal Keratopathy in a Patient With Multiple Myeloma.
abstract: OBJECTIVE
  To report a case of asymmetric deep stromal keratopathy in a patient with multiple myeloma.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  An 85-year-old woman was found to have progressive visually significant left-sided deep stromal opacity in the setting of monoclonal gammopathy. Hematologic workup resulted in a diagnosis of IgG kappa multiple myeloma. Histopathology was significant for semicrystalline deposits in the posterior stroma. The patient's visual acuity improved to 20/50 7 months after penetrating keratoplasty. A similar deep stromal lesion appeared in the right eye 2 years after initial presentation.
  
  
  CONCLUSIONS
  We present an unusual case of paraproteinemic keratopathy with a uniquely asymmetric presentation that resulted in a diagnosis of multiple myeloma.
authors.affiliation: *Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT; †New England Retina Associates, Hamden, CT; and Departments of ‡Pathology; and §Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Laurel T
authors.initials: LT
authors.lastname: Tainsh
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Coady
authors.forename: John H
authors.initials: JH
authors.lastname: Sinard
authors.forename: Natalia
authors.initials: N
authors.lastname: Neparidze
authors.forename: Seth W
authors.initials: SW
authors.lastname: Meskin
authors.forename: Ron A
authors.initials: RA
authors.lastname: Adelman
authors.forename: Jessica
authors.initials: J
authors.lastname: Chow
mesh_terms: D000369:Aged, 80 and over; D003318:Corneal Opacity / Q000175:diagnosis* / Q000601:surgery; D003319:Corneal Stroma / Q000473:pathology*; D005260:Female; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000276:immunology; D015948:Keratoplasty, Penetrating; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000276:immunology; D010265:Paraproteinemias / Q000175:diagnosis* / Q000276:immunology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D007145:Immunoglobulin kappa-Chains