Purpose. To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbiditie... more Purpose. To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities in subjects with monoclonal gammopathy. Patients and Methods. We analyzed patients from two large referral hematology centers in Budapest, diagnosed and/or treated with monoclonal gammopathy between 1997 and 2020. As a control group, randomly selected individuals of the same age group, without hematological disease, have been included. There were 160 eyes of 80 patients (38.75% males; age 67.61 ± 10.48 (range: 38–85) years) with monoclonal gammopathy and 86 eyes of 43 control subjects (32.56% males; age 62.44 ± 11.89 (range 37–86) years). The hematological diagnosis was MGUS in 9 (11.25%), multiple myeloma in 61 (76.25%), smoldering myeloma in 6 (7.50%), and amyloidosis or Waldenström macroglobulinemia in 2 cases (2.50%–2.50%). Before detailed ophthalmic examination with fundoscopy, 42 subjects with gammopathy (52.50%) and all controls filled the Ocular Surface Disease Index (OSDI) que...
Purpose. Keratoconus (KC) has been defined as a "noninflammatory" corneal disease, but recent stu... more Purpose. Keratoconus (KC) has been defined as a "noninflammatory" corneal disease, but recent studies have noted a potential inflammatory origin. We analysed the Ocular Surface Disease Index (OSDI) and ocular surface temperature (OST) in KC patients compared to controls. Patients and Methods. A total of 179 eyes in 90 patients with KC (topographic keratoconus classification 0-1 to 4, age 36.1 ± 12.5 years, 65.9% males) and 82 eyes in 41 controls (age 36.4 ± 12.8 years, 47.6% males) were examined. e participants completed the OSDI questionnaire and underwent corneal topography, tomography, and thermography. Additional outcome measures were vision-and discomfort-related OSDI subscores and mean OST at the corneal centre during 10 seconds of sustained eye opening after blinking. Results. e OSDI score (31.4 ± 22.4 vs. 17.5 ± 17.9) and vision-(17.7 ± 14.6 vs. 10.5 ± 13.2) and discomfort-related (14.3 ± 10.7 vs. 9.4 ± 10.5) OSDI subscores were significantly higher in KC patients than in controls (p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; p � 0.41) between the two groups (p ≥ 0.22). e OSDI score and subscores poorly to fairly correlated with the surface asymmetry index (SAI) and surface regularity index (SRI; r > 0.174, p < 0.005), but did not correlate with the central corneal OST (r < 0.001). OST also did not correlate with the SAI, SRI, and central corneal thickness (r ≥ − 0.086). Conclusion. KC patients had increased OSDI scores and vision-and discomfort-related OSDI subscores without an increase in the OST compared to a normal population. OSDI score/subscores weakly correlate with SAI and SRI but do not correlate with OST in KC patients or controls. Vision-and discomfort-related symptoms of KC have to be managed in parallel in ophthalmological practice, but the necessity of antiinflammatory treatment cannot be verified through ocular thermography.
Összefoglaló. Célkitűzés: A monoklonális fehérjetermeléssel járó haematológiai kórképek szemészet... more Összefoglaló. Célkitűzés: A monoklonális fehérjetermeléssel járó haematológiai kórképek szemészeti tüneteinek és szemészeti társbetegségeinek összefoglalása irodalmi adatok alapján. Módszer: A Pubmedben rendelkezésre álló adatok kigyűjtése, elemzése és összefoglalása. Eredmények: Immunglobulin-lerakódás a szem szövetei közül leggyakrabban a szaruhártyában figyelhető meg (paraproteinaemiás vagy immuntaktoid keratopathia). A monoklonális fehérjeszaporulattal járó plazmasejtes betegség gyakoribb szemészeti jelei pedig a paraproteinaemiás keratopathia mellett a kristályhordozó histiocytosis (CSH), a hypercupremiás keratopathia, a foveolaris drusen/maculopathia és az orbitalis plasmocytoma. A ritkább szemészeti jelek/tünetek közé az akut/krónikus uveitis, a Doyne retina dystrophia és az arteria vagy vena centralis retinae elzáródása tartoznak. Szemészeti mellékhatás szisztémás szteroidok és a belantamab mafotidin alkalmazásakor jelentkeznek. Következtetések: A monoklonális gammopathiával...
Purpose To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities... more Purpose To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities in subjects with monoclonal gammopathy. Patients and Methods. We analyzed patients from two large referral hematology centers in Budapest, diagnosed and/or treated with monoclonal gammopathy between 1997 and 2020. As a control group, randomly selected individuals of the same age group, without hematological disease, have been included. There were 160 eyes of 80 patients (38.75% males; age 67.61 ± 10.48 (range: 38–85) years) with monoclonal gammopathy and 86 eyes of 43 control subjects (32.56% males; age 62.44 ± 11.89 (range 37–86) years). The hematological diagnosis was MGUS in 9 (11.25%), multiple myeloma in 61 (76.25%), smoldering myeloma in 6 (7.50%), and amyloidosis or Waldenström macroglobulinemia in 2 cases (2.50%–2.50%). Before detailed ophthalmic examination with fundoscopy, 42 subjects with gammopathy (52.50%) and all controls filled the Ocular Surface Disease Index (OSDI) ques...
Összefoglaló. Célkitűzés: A monoklonális gammopathia szemészeti jeleinek és szövődményeinek vizsg... more Összefoglaló. Célkitűzés: A monoklonális gammopathia szemészeti jeleinek és szövődményeinek vizsgálata. Betegek és módszerek: Két nagy budapesti hematológiai ellátóhely 1999 és 2020 között diagnosztizált és/vagy kezelt, monoklonális gammopathiát mutató betegeit vizsgáltuk (42 beteg 84 szeme, 42,86% férfi; átlagéletkor 63,83 ± 10,76 év). A hematológiai diagnózis 3 esetben bizonytalan jelentőségű monoklonális gammopathia, 34 esetben myeloma multiplex, 3 esetben parázsló myeloma, 1-1 esetben Waldenström-macroglobulinaemia és amyloidosis voltak. Kontrollcsoportként véletlenszerűen kiválasztott, hasonló korcsoportú, hematológiai betegség nélküli egyéneket vizsgáltunk (43 beteg 86 szeme, 32,56% férfi; átlagéletkor 62,44 ± 11,89 év). A szemészeti vizsgálat előtt minden személy kitöltötte a Szemfelszíni Betegség Index (OSDI-) kérdőívet. A szemészeti vizsgálat során a látóélesség vizsgálata mellett pupillatágítást követően réslámpás vizsgálatot végeztünk. Eredmények: Monoklonális gammopathiá...
Purpose: In keratoconus (KC), an increase of the corneal back surface area may result in endothel... more Purpose: In keratoconus (KC), an increase of the corneal back surface area may result in endothelial cell density (ECD) decrease and an increase of the corneal front surface area in ocular surface temperature (OST) decrease due to increased heat dissipation. Along with these hypotheses, we aimed to analyse the correlation between ECD and central corneal OST in patients with KC and healthy controls. Patients and methods: A total of 154 eyes with KC (mean age 36.1 ± 12.5 years) and 92 healthy eyes (mean age 36.4 ± 12.8 years) were examined. Corneal front and back surface area at the central 5 mm corneal diameter (FSA and BSA) were calculated based on Pentacam measurement data: FSA or BSA = 2×3.14×R(R-√R 2-D/2) 2 , where R referred to corneal front or back surface radius of curvature and D to the corneal front or back surface diameter (5 mm for the present study), respectively. ECD was determined by specular microscopy (EM-3000) and central corneal OST by thermography (TG-1000). Results: ECD was significantly lower in KC (2498 ± 356/mm 2) patients than in controls (2638 ± 294/mm 2 ; p < .001). FSA (20.35 ± 0.26 mm 2 vs. 20.17 ± 0.03 mm 2) and BSA (20.84 ± 0.58 mm 2 vs. 20.45 ± 0.08 mm 2) were significantly higher in KC patients than in controls (p = .001; p < .001), but the average central corneal OST did not differ significantly between both groups (34.2 ± 0.6°C vs.34.3 ± 0.7°C; p = .62). OST at the corneal centre correlated weakly, positively with ECD (r = 0.2; p < .05), but OST did not correlate with FSA (r = 0.045) or BSA (r = 0.064). Conclusions: Endothelial cell density seems to have a mild impact on central ocular surface temperature in keratoconus and normal subjects. This effect is not correlated to the corneal front or back surface area.
Purpose. To analyse the clinical and microbiological characteristics and preexisting ophthalmic a... more Purpose. To analyse the clinical and microbiological characteristics and preexisting ophthalmic and systemic conditions of infectious keratitis resulting in enucleation/evisceration in a large tertiary referral center in a developed country (Hungary) over a period of 12 years. Patients and Methods. A retrospective review of enucleated/eviscerated eyes undergoing surgery between 2007 and 2018 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary, with infectious keratitis as the primary indication for enucleation or evisceration. For each subject, clinical history, B-scan ultrasound report, and microbiological analyses were reviewed. Results. There were 48 enucleated/eviscerated eyes from 47 patients (29 females (61.7%), age at the time of surgery 66.4 ± 18.5 years). Indication for surgery was hopeless, unmanageable keratitis (62.5%), and keratitis with endophthalmitis (37.5%). The most common preexisting ophthalmic conditions were previous cataract surgery (...
Purpose. Keratoconus (KC) has been defined as a “noninflammatory” corneal disease, but recent stu... more Purpose. Keratoconus (KC) has been defined as a “noninflammatory” corneal disease, but recent studies have noted a potential inflammatory origin. We analysed the Ocular Surface Disease Index (OSDI) and ocular surface temperature (OST) in KC patients compared to controls. Patients and Methods. A total of 179 eyes in 90 patients with KC (topographic keratoconus classification 0-1 to 4, age 36.1 ± 12.5 years, 65.9% males) and 82 eyes in 41 controls (age 36.4 ± 12.8 years, 47.6% males) were examined. The participants completed the OSDI questionnaire and underwent corneal topography, tomography, and thermography. Additional outcome measures were vision- and discomfort-related OSDI subscores and mean OST at the corneal centre during 10 seconds of sustained eye opening after blinking. Results. The OSDI score (31.4 ± 22.4 vs. 17.5 ± 17.9) and vision- (17.7 ± 14.6 vs. 10.5 ± 13.2) and discomfort-related (14.3 ± 10.7 vs. 9.4 ± 10.5) OSDI subscores were significantly higher in KC patients tha...
A sérüléstől az ellátásig eltelt átlagos idő 1,3 nap volt. A sérülések kapcsán átlagosan kórházba... more A sérüléstől az ellátásig eltelt átlagos idő 1,3 nap volt. A sérülések kapcsán átlagosan kórházban töltött idő 5,2 nap, az átlagos obszervációs idő 9,7 hónap volt. A szemsérülések 95,8%-a mechanikai sérülés volt, melyből 74,2% szemgolyóra lokalizálódó sérülés, 20,4% adnexumokat érintő, 5,4% destruktív szemsérülés volt. A szemgolyót ért sérülések között 15 zárt, 60 a bulbus megnyílásával járó szemsérülés volt, és 21 esetben került idegen test a szemgolyóba. Az esetek 93%-ában sikerült megőrizni vagy javítani a beteg legjobb korrigált látóélességét az ellátás során. Következtetés: A kibővített klasszifikáció segítségével az osztályos ellátást igénylő összes szemsérülés csoportosíthatóvá vált. A szemsérülés mértékétől függően az időben megfelelő ellátásban részesülő szemsérülések esetén javítható vagy megőrizhető a látóélesség.
neal opacifications were detected predescemetally, that were progressing and reaching the optical... more neal opacifications were detected predescemetally, that were progressing and reaching the optical centre during follow-up. With 0.15 best corrected visual acuity, penetrating keratoplasty was performed (postoperative best spectaclecorrected visual acuity 0.6). Masson trichrom staining of the explanted cornea verified protein deposition, immunhistochemistry identified kappa light chain immunglobulin deposition in the posterior stroma, surrounded with inflammatory cells. Serum electrophoresis and bone marrow biopsy of our patient proved MGUS, therefore, hematological follow-up is going on. In the case of progressive, atypical corneal opacification, the hematological diagnosis of monoclonal gammopathy must be excluded-monoclonal gammopathy of ocular significance-, as delay in proper diagnosis and treatment of the systemic disease may have devastating consequences.
Purpose. To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbiditie... more Purpose. To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities in subjects with monoclonal gammopathy. Patients and Methods. We analyzed patients from two large referral hematology centers in Budapest, diagnosed and/or treated with monoclonal gammopathy between 1997 and 2020. As a control group, randomly selected individuals of the same age group, without hematological disease, have been included. There were 160 eyes of 80 patients (38.75% males; age 67.61 ± 10.48 (range: 38–85) years) with monoclonal gammopathy and 86 eyes of 43 control subjects (32.56% males; age 62.44 ± 11.89 (range 37–86) years). The hematological diagnosis was MGUS in 9 (11.25%), multiple myeloma in 61 (76.25%), smoldering myeloma in 6 (7.50%), and amyloidosis or Waldenström macroglobulinemia in 2 cases (2.50%–2.50%). Before detailed ophthalmic examination with fundoscopy, 42 subjects with gammopathy (52.50%) and all controls filled the Ocular Surface Disease Index (OSDI) que...
Purpose. Keratoconus (KC) has been defined as a "noninflammatory" corneal disease, but recent stu... more Purpose. Keratoconus (KC) has been defined as a "noninflammatory" corneal disease, but recent studies have noted a potential inflammatory origin. We analysed the Ocular Surface Disease Index (OSDI) and ocular surface temperature (OST) in KC patients compared to controls. Patients and Methods. A total of 179 eyes in 90 patients with KC (topographic keratoconus classification 0-1 to 4, age 36.1 ± 12.5 years, 65.9% males) and 82 eyes in 41 controls (age 36.4 ± 12.8 years, 47.6% males) were examined. e participants completed the OSDI questionnaire and underwent corneal topography, tomography, and thermography. Additional outcome measures were vision-and discomfort-related OSDI subscores and mean OST at the corneal centre during 10 seconds of sustained eye opening after blinking. Results. e OSDI score (31.4 ± 22.4 vs. 17.5 ± 17.9) and vision-(17.7 ± 14.6 vs. 10.5 ± 13.2) and discomfort-related (14.3 ± 10.7 vs. 9.4 ± 10.5) OSDI subscores were significantly higher in KC patients than in controls (p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; p � 0.41) between the two groups (p ≥ 0.22). e OSDI score and subscores poorly to fairly correlated with the surface asymmetry index (SAI) and surface regularity index (SRI; r > 0.174, p < 0.005), but did not correlate with the central corneal OST (r < 0.001). OST also did not correlate with the SAI, SRI, and central corneal thickness (r ≥ − 0.086). Conclusion. KC patients had increased OSDI scores and vision-and discomfort-related OSDI subscores without an increase in the OST compared to a normal population. OSDI score/subscores weakly correlate with SAI and SRI but do not correlate with OST in KC patients or controls. Vision-and discomfort-related symptoms of KC have to be managed in parallel in ophthalmological practice, but the necessity of antiinflammatory treatment cannot be verified through ocular thermography.
Összefoglaló. Célkitűzés: A monoklonális fehérjetermeléssel járó haematológiai kórképek szemészet... more Összefoglaló. Célkitűzés: A monoklonális fehérjetermeléssel járó haematológiai kórképek szemészeti tüneteinek és szemészeti társbetegségeinek összefoglalása irodalmi adatok alapján. Módszer: A Pubmedben rendelkezésre álló adatok kigyűjtése, elemzése és összefoglalása. Eredmények: Immunglobulin-lerakódás a szem szövetei közül leggyakrabban a szaruhártyában figyelhető meg (paraproteinaemiás vagy immuntaktoid keratopathia). A monoklonális fehérjeszaporulattal járó plazmasejtes betegség gyakoribb szemészeti jelei pedig a paraproteinaemiás keratopathia mellett a kristályhordozó histiocytosis (CSH), a hypercupremiás keratopathia, a foveolaris drusen/maculopathia és az orbitalis plasmocytoma. A ritkább szemészeti jelek/tünetek közé az akut/krónikus uveitis, a Doyne retina dystrophia és az arteria vagy vena centralis retinae elzáródása tartoznak. Szemészeti mellékhatás szisztémás szteroidok és a belantamab mafotidin alkalmazásakor jelentkeznek. Következtetések: A monoklonális gammopathiával...
Purpose To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities... more Purpose To examine the ocular signs of monoclonal gammopathy and to evaluate ocular comorbidities in subjects with monoclonal gammopathy. Patients and Methods. We analyzed patients from two large referral hematology centers in Budapest, diagnosed and/or treated with monoclonal gammopathy between 1997 and 2020. As a control group, randomly selected individuals of the same age group, without hematological disease, have been included. There were 160 eyes of 80 patients (38.75% males; age 67.61 ± 10.48 (range: 38–85) years) with monoclonal gammopathy and 86 eyes of 43 control subjects (32.56% males; age 62.44 ± 11.89 (range 37–86) years). The hematological diagnosis was MGUS in 9 (11.25%), multiple myeloma in 61 (76.25%), smoldering myeloma in 6 (7.50%), and amyloidosis or Waldenström macroglobulinemia in 2 cases (2.50%–2.50%). Before detailed ophthalmic examination with fundoscopy, 42 subjects with gammopathy (52.50%) and all controls filled the Ocular Surface Disease Index (OSDI) ques...
Összefoglaló. Célkitűzés: A monoklonális gammopathia szemészeti jeleinek és szövődményeinek vizsg... more Összefoglaló. Célkitűzés: A monoklonális gammopathia szemészeti jeleinek és szövődményeinek vizsgálata. Betegek és módszerek: Két nagy budapesti hematológiai ellátóhely 1999 és 2020 között diagnosztizált és/vagy kezelt, monoklonális gammopathiát mutató betegeit vizsgáltuk (42 beteg 84 szeme, 42,86% férfi; átlagéletkor 63,83 ± 10,76 év). A hematológiai diagnózis 3 esetben bizonytalan jelentőségű monoklonális gammopathia, 34 esetben myeloma multiplex, 3 esetben parázsló myeloma, 1-1 esetben Waldenström-macroglobulinaemia és amyloidosis voltak. Kontrollcsoportként véletlenszerűen kiválasztott, hasonló korcsoportú, hematológiai betegség nélküli egyéneket vizsgáltunk (43 beteg 86 szeme, 32,56% férfi; átlagéletkor 62,44 ± 11,89 év). A szemészeti vizsgálat előtt minden személy kitöltötte a Szemfelszíni Betegség Index (OSDI-) kérdőívet. A szemészeti vizsgálat során a látóélesség vizsgálata mellett pupillatágítást követően réslámpás vizsgálatot végeztünk. Eredmények: Monoklonális gammopathiá...
Purpose: In keratoconus (KC), an increase of the corneal back surface area may result in endothel... more Purpose: In keratoconus (KC), an increase of the corneal back surface area may result in endothelial cell density (ECD) decrease and an increase of the corneal front surface area in ocular surface temperature (OST) decrease due to increased heat dissipation. Along with these hypotheses, we aimed to analyse the correlation between ECD and central corneal OST in patients with KC and healthy controls. Patients and methods: A total of 154 eyes with KC (mean age 36.1 ± 12.5 years) and 92 healthy eyes (mean age 36.4 ± 12.8 years) were examined. Corneal front and back surface area at the central 5 mm corneal diameter (FSA and BSA) were calculated based on Pentacam measurement data: FSA or BSA = 2×3.14×R(R-√R 2-D/2) 2 , where R referred to corneal front or back surface radius of curvature and D to the corneal front or back surface diameter (5 mm for the present study), respectively. ECD was determined by specular microscopy (EM-3000) and central corneal OST by thermography (TG-1000). Results: ECD was significantly lower in KC (2498 ± 356/mm 2) patients than in controls (2638 ± 294/mm 2 ; p < .001). FSA (20.35 ± 0.26 mm 2 vs. 20.17 ± 0.03 mm 2) and BSA (20.84 ± 0.58 mm 2 vs. 20.45 ± 0.08 mm 2) were significantly higher in KC patients than in controls (p = .001; p < .001), but the average central corneal OST did not differ significantly between both groups (34.2 ± 0.6°C vs.34.3 ± 0.7°C; p = .62). OST at the corneal centre correlated weakly, positively with ECD (r = 0.2; p < .05), but OST did not correlate with FSA (r = 0.045) or BSA (r = 0.064). Conclusions: Endothelial cell density seems to have a mild impact on central ocular surface temperature in keratoconus and normal subjects. This effect is not correlated to the corneal front or back surface area.
Purpose. To analyse the clinical and microbiological characteristics and preexisting ophthalmic a... more Purpose. To analyse the clinical and microbiological characteristics and preexisting ophthalmic and systemic conditions of infectious keratitis resulting in enucleation/evisceration in a large tertiary referral center in a developed country (Hungary) over a period of 12 years. Patients and Methods. A retrospective review of enucleated/eviscerated eyes undergoing surgery between 2007 and 2018 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary, with infectious keratitis as the primary indication for enucleation or evisceration. For each subject, clinical history, B-scan ultrasound report, and microbiological analyses were reviewed. Results. There were 48 enucleated/eviscerated eyes from 47 patients (29 females (61.7%), age at the time of surgery 66.4 ± 18.5 years). Indication for surgery was hopeless, unmanageable keratitis (62.5%), and keratitis with endophthalmitis (37.5%). The most common preexisting ophthalmic conditions were previous cataract surgery (...
Purpose. Keratoconus (KC) has been defined as a “noninflammatory” corneal disease, but recent stu... more Purpose. Keratoconus (KC) has been defined as a “noninflammatory” corneal disease, but recent studies have noted a potential inflammatory origin. We analysed the Ocular Surface Disease Index (OSDI) and ocular surface temperature (OST) in KC patients compared to controls. Patients and Methods. A total of 179 eyes in 90 patients with KC (topographic keratoconus classification 0-1 to 4, age 36.1 ± 12.5 years, 65.9% males) and 82 eyes in 41 controls (age 36.4 ± 12.8 years, 47.6% males) were examined. The participants completed the OSDI questionnaire and underwent corneal topography, tomography, and thermography. Additional outcome measures were vision- and discomfort-related OSDI subscores and mean OST at the corneal centre during 10 seconds of sustained eye opening after blinking. Results. The OSDI score (31.4 ± 22.4 vs. 17.5 ± 17.9) and vision- (17.7 ± 14.6 vs. 10.5 ± 13.2) and discomfort-related (14.3 ± 10.7 vs. 9.4 ± 10.5) OSDI subscores were significantly higher in KC patients tha...
A sérüléstől az ellátásig eltelt átlagos idő 1,3 nap volt. A sérülések kapcsán átlagosan kórházba... more A sérüléstől az ellátásig eltelt átlagos idő 1,3 nap volt. A sérülések kapcsán átlagosan kórházban töltött idő 5,2 nap, az átlagos obszervációs idő 9,7 hónap volt. A szemsérülések 95,8%-a mechanikai sérülés volt, melyből 74,2% szemgolyóra lokalizálódó sérülés, 20,4% adnexumokat érintő, 5,4% destruktív szemsérülés volt. A szemgolyót ért sérülések között 15 zárt, 60 a bulbus megnyílásával járó szemsérülés volt, és 21 esetben került idegen test a szemgolyóba. Az esetek 93%-ában sikerült megőrizni vagy javítani a beteg legjobb korrigált látóélességét az ellátás során. Következtetés: A kibővített klasszifikáció segítségével az osztályos ellátást igénylő összes szemsérülés csoportosíthatóvá vált. A szemsérülés mértékétől függően az időben megfelelő ellátásban részesülő szemsérülések esetén javítható vagy megőrizhető a látóélesség.
neal opacifications were detected predescemetally, that were progressing and reaching the optical... more neal opacifications were detected predescemetally, that were progressing and reaching the optical centre during follow-up. With 0.15 best corrected visual acuity, penetrating keratoplasty was performed (postoperative best spectaclecorrected visual acuity 0.6). Masson trichrom staining of the explanted cornea verified protein deposition, immunhistochemistry identified kappa light chain immunglobulin deposition in the posterior stroma, surrounded with inflammatory cells. Serum electrophoresis and bone marrow biopsy of our patient proved MGUS, therefore, hematological follow-up is going on. In the case of progressive, atypical corneal opacification, the hematological diagnosis of monoclonal gammopathy must be excluded-monoclonal gammopathy of ocular significance-, as delay in proper diagnosis and treatment of the systemic disease may have devastating consequences.
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