Decreased keratocyte density and central corneal thickness in primary open‑angle glaucoma patients undergoing treatment with topical prostaglandin analogues.

Purpose: To evaluate whether prostaglandin (PG) analogue use is associated with alterations in keratocyte density and central corneal thickness (CCT) in subjects with primary open‑angle glaucoma (POAG). Materials and Methods: Thirty‑five POAG patients treated with PG analogues for >2 years and 35 control subjects without glaucoma were included in this cross‑sectional study. All subjects were underwent CCT measurements using ultrasound pachymetry. Keratocyte densities of each stromal layer were determined by in vivo confocal microscopy. Student’s t‑test and Chi‑square test were used for statistical evaluations. Correlations between keratocyte densities and CCT were analyzed using Pearson’s correlation analysis. Results: Keratocyte densities in each stromal layer were significantly lower in glaucoma patients receiving PG analogues as compared to those of controls (P < 0.001). The mean CCT was also lower in glaucoma patients (515.2 ± 18.8 μ) than control subjects (549.6 ± 21.1 μ, P < 0.001). A positive correlation between keratocyte densities in each stromal layer and CCT was observed in POAG patients. Conclusions: Long‑term administration of topical PG analogues may adversely influence keratocyte densities and CCT. Further prospective studies are required clarify the relationship between PG analogues and their effects on the cornea.

In vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases.

In this paper, we report two cases of a 62‑year‑old patient presented with blurred vision and a 45‑year‑old male diagnosed with multiple myeloma who was referred from the Department of Oncology. Slit‑lamp examination, in vivo confocal microscopy (IVCM), systemic work‑up and serum protein electrophoresis were obtained. In both patients, slit‑lamp findings revealed bilateral diffuse subepithelial and anterior stromal crystals and IVCM showed highly reflective deposits in the corneal epithelium and stroma. The first patient was eventually diagnosed with monoclonal gammopathy of undetermined significance following bone marrow biopsy and systemic evaluation. Unusual corneal deposits may constitute the first sign of monoclonal gammopathies. IVCM may be helpful in showing the crystalline nature of the corneal deposits and guiding the clinician to the diagnosis of gammopathies. Both ophthalmologists and oncologists should be aware that corneal deposits may herald a life‑threatening hematologic disease.