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Chameleon-like appearance of immunotactoid keratopathy
To demonstrate five different opacity patterns in benign monoclonal gammopathy (BMG). Differential diagnosis (DD) against hereditary and degenerative corneal disorders. First follow-up of one patient with BMG L-kappa.
Walter Lisch Hanau ; Germany
Fig.1A. ITK-crystals
DD
Fig.1B. Cystinosis
Fig.2A. ITK-lattice Fig.2C. ITK-diffuse
Fig.2B. Lattice CD
Fig. 3A. ITK- granular
Fig.3B.Granular CD 1
Fig.4A. ITK- band
Fig.4B. LCAT
Fig.5A. ITK-patches
Fig.5B.Salzmann
.
The author has no financial interest in the subject matter of this poster
Address :Walter Lisch MDKurt-Blaum-Platz 863450 HanauGermany
Purpose
1
Chameleon-like appearance of immunotactoid keratopathy Walter Lisch Hanau ; Germany
Fig.1A. ITK-crystals
DD
Fig.2A. ITK-lattice Fig.2C. ITK-diffuse Fig. 3A. ITK- granular
Fig.3B.Granular CD 1
Fig.4A. ITK- band
Fig.4B. LCAT
Fig.5A. ITK-patches
Fig.5B.Salzmann
.
The author has no financial interest in the subject matter of this poster
Address :Walter Lisch MDKurt-Blaum-Platz 863450 HanauGermany
Methods
Colored slit-lamp photo-documentation of five BGM L-kappa patients with different types of immunotactoid keratopathy (ITK) : Pat. 1 : Classical crystalline-like ITK (Fig.1A); Pat. 2 : Central lattice-like ITK in 1992 (Fig. 2A ) and moderate diffuse-like ITK in 2009 (Fig.2C); Pat. 3 : Peripheral granular-like ITK (Fig 3A); Pat. 4 : Peripheral band-like ITK (Fig.4A); Pat. 5 : Peripheral patches-like ITK (Fig.5A). Systemic and serological examination of all five patients.
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Fig.1B. Cystinosis
Fig.2B. Lattice CD
Chameleon-like appearance of immunotactoid keratopathy Walter Lisch Hanau ; Germany
Fig.1A. ITK-crystals
DD
Fig.2A. ITK-lattice Fig.2C. ITK-diffuse Fig. 3A. ITK- granular
Fig.3B.Granular CD 1
Fig.4A. ITK- band
Fig.4B. LCAT
Fig.5A. ITK-patches
Fig.5B.Salzmann
.
The author has no financial interest in the subject matter of this poster
Address :Walter Lisch MDKurt-Blaum-Platz 863450 HanauGermany
Results
The systemic and serologic examination disclose in all five patients a BMG L-kappa.The 17-year follow-up of Pat.2 shows a change and
reduction of the corneal opacities due to a strict lower protein nutrition (Fig.2A and 2C).Differential diagnosis : Pat.1 against cystinosis
(Fig.1B) and Schnyder; Pat.2 against lattice CD (Fig.2B); Pat.3 against granular CD 1 (Fig.3B); Pat.4 against arcus lipoides and LCAT (Fig.4B); Pat.5 against gelatinous CD and Salzmann (Fig.5B).
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Fig.1B. Cystinosis
Fig.2B. Lattice CD
Chameleon-like appearance of immunotactoid keratopathy Walter Lisch Hanau ; Germany
Fig.1A. ITK-crystals
DD
Fig.2A. ITK-lattice Fig.2C. ITK-diffuse Fig. 3A. ITK- granular
Fig.3B.Granular CD 1
Fig.4A. ITK- band
Fig.4B. LCAT
Fig.5A. ITK-patches
Fig.5B.Salzmann
.
The author has no financial interest in the subject matter of this poster
Address :Walter Lisch MDKurt-Blaum-Platz 863450 HanauGermany
Conclusions ITK can mimick some forms of hereditary and degenerative corneal disorders(1). ITK
can be the first symptom of BGM. An annual internal check of BGM is to recommend because of the occurrence of malign MG in 20% of cases(2).
References 1) Garibaldi DC et al. Surv Ophthalmol. 2005;50:61-80 2) Spiegel P et al. Cornea. 1990;9/1:81-85
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Fig.1B. Cystinosis
Fig.2B. Lattice CD
