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Immunoglobulin Deposition in the Cornea After Application of Autologous Serum

Immunoglobulin Deposition in the Cornea After Application of Autologous Serum Abstract • A 47-year-old man with a history of multiple corneal allografts for recurrent herpes simplex keratitis developed a subtotal nonhealing corneal epithelial defect. The patient was treated with hourly drops of autologous serum. A ringlike infiltrate was subsequently observed, followed by reepithelialization of the graft. The patient later suffered allograft rejection of the cornea and recurrence of the epithelial defect, and a repeated penetrating keratoplasty was performed. Examination of the excised button demonstrated a total epithelial defect, changes compatible with allograft rejection, and, in addition, eosinophilic granular deposits within the superficial corneal stroma that corresponded to the "immune ring" observed clinically. Immunoperoxidase staining was positive for IgG, IgM, IgA, and κ and λ light chains. These pathologic changes lend credence to the hypothesis that the precorneal tear film may be a source of immunoglobulin that becomes deposited within the stroma. References 1. Meesmann A: Uber eine eigenartige Hornhautdegeneration? (Ablagerung des Bence-Joonesschen Elweisskorpers in der Hornhaut.) Fortschr Ophthalmol 1934;50:311-315. 2. Burki E: Uber Hornhautveranderungen bei einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 1958;135:565-572.Crossref 3. Aronson SB, Shaw R: Corneal crystals in multiple myeloma . Arch Ophthalmol 1959;61:541-546.Crossref 4. Klintworth GK, Bredehoeft SJ, Reed JW: Analysis of corneal crystalline deposits in multiple myeloma . Am J Ophthalmol 1978;86:303-313. 5. Rodrigues MM, Krachmer JH, Miller SD, et al: Posterior corneal crystalline deposits in benign monoclonal gammopathy: A clinicopathologic case report . Arch Ophthalmol 1979;97:124-128.Crossref 6. Blobner F: Kristallinische Degeneration der Bindehaut und Hornhaut . Klin Monatsbl Augenheilkd 1938;100:588-593. 7. Markoff N: Ueber Kristallbildung in der Hornhaut bei Urethantherapie des Myeloms . Schweiz Med Wochenschr 1948;78:987-988. 8. Francois J, Rabaey M: Corneal dystrophy and paraproteinemia . Am J Ophthalmol 1961;52:895-901. 9. Laibson PR, Damiano VV: X-ray and electron diffraction of ocular and bone marrow crystals in paraproteinemia . Science 1969;163:581-583.Crossref 10. Palazon Godinez A: Depot de cristaux dans la cornee . Am Hosp Adela 1933;4:235-237. 11. Palm E: A case of crystal deposits in the cornea: Precipitation of a spontaneously crystallizing plasma globulin . Acta Ophthalmol 1947;25:165-174.Crossref 12. Pinkerton RMH, Robertson DM: Corneal and conjunctival changes in dysproteinemia . Invest Ophthalmol 1969;8:357-364. 13. Miller KH, Green WR, Stark WJ, et al: Immunoprotein deposition in the cornea . Ophthalmology 1980;87:944-950.Crossref 14. Rao NA, Font RL: Plasmacytic conjunctivitis with crystalline inclusions: Immunohistochemical and ultrastructural studies . Arch Ophthalmol 1980;98:836-841.Crossref 15. Ormerod LD, Collin HB, Dohlman CH, et al: Paraproteinemic crystalline keratopathy . Ophthalmology 1988;95:202-212.Crossref 16. Theodore FH, Jakobiec FA, Juechter KB, et al: The diagnostic value of a ring infiltrate in acanthamoebic keratitis . Ophthalmology 1985;92:1471-1479.Crossref 17. Epstein DL, Paton D: Keratitis from misuse of corneal anesthetics . N Engl J Med 1968;279:396-399.Crossref 18. Smolin G, O'Connor GR: Immunologic reactions limited to the external eye , in Ocular Immunology . Philadelphia, Lea & Febiger, 1981, chap 4. 19. Yassa NH, Font RL, Fine BS, et al: Corneal immunoglobulin deposition in the posterior stroma: A case report including immunohistochemical and ultrastructural observations . Arch Ophthalmol 1987;105:99-103.Crossref 20. Fujikawa LS, Foster CS, Harrist TJ, et al: Fibronectin in healing rabbit corneal wounds . Lab Invest 1981;45:120-129. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Immunoglobulin Deposition in the Cornea After Application of Autologous Serum

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1988.01060140587028
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 47-year-old man with a history of multiple corneal allografts for recurrent herpes simplex keratitis developed a subtotal nonhealing corneal epithelial defect. The patient was treated with hourly drops of autologous serum. A ringlike infiltrate was subsequently observed, followed by reepithelialization of the graft. The patient later suffered allograft rejection of the cornea and recurrence of the epithelial defect, and a repeated penetrating keratoplasty was performed. Examination of the excised button demonstrated a total epithelial defect, changes compatible with allograft rejection, and, in addition, eosinophilic granular deposits within the superficial corneal stroma that corresponded to the "immune ring" observed clinically. Immunoperoxidase staining was positive for IgG, IgM, IgA, and κ and λ light chains. These pathologic changes lend credence to the hypothesis that the precorneal tear film may be a source of immunoglobulin that becomes deposited within the stroma. References 1. Meesmann A: Uber eine eigenartige Hornhautdegeneration? (Ablagerung des Bence-Joonesschen Elweisskorpers in der Hornhaut.) Fortschr Ophthalmol 1934;50:311-315. 2. Burki E: Uber Hornhautveranderungen bei einem Fall von multiplem Myelom (Plasmocytom) . Ophthalmologica 1958;135:565-572.Crossref 3. Aronson SB, Shaw R: Corneal crystals in multiple myeloma . Arch Ophthalmol 1959;61:541-546.Crossref 4. Klintworth GK, Bredehoeft SJ, Reed JW: Analysis of corneal crystalline deposits in multiple myeloma . Am J Ophthalmol 1978;86:303-313. 5. Rodrigues MM, Krachmer JH, Miller SD, et al: Posterior corneal crystalline deposits in benign monoclonal gammopathy: A clinicopathologic case report . Arch Ophthalmol 1979;97:124-128.Crossref 6. Blobner F: Kristallinische Degeneration der Bindehaut und Hornhaut . Klin Monatsbl Augenheilkd 1938;100:588-593. 7. Markoff N: Ueber Kristallbildung in der Hornhaut bei Urethantherapie des Myeloms . Schweiz Med Wochenschr 1948;78:987-988. 8. Francois J, Rabaey M: Corneal dystrophy and paraproteinemia . Am J Ophthalmol 1961;52:895-901. 9. Laibson PR, Damiano VV: X-ray and electron diffraction of ocular and bone marrow crystals in paraproteinemia . Science 1969;163:581-583.Crossref 10. Palazon Godinez A: Depot de cristaux dans la cornee . Am Hosp Adela 1933;4:235-237. 11. Palm E: A case of crystal deposits in the cornea: Precipitation of a spontaneously crystallizing plasma globulin . Acta Ophthalmol 1947;25:165-174.Crossref 12. Pinkerton RMH, Robertson DM: Corneal and conjunctival changes in dysproteinemia . Invest Ophthalmol 1969;8:357-364. 13. Miller KH, Green WR, Stark WJ, et al: Immunoprotein deposition in the cornea . Ophthalmology 1980;87:944-950.Crossref 14. Rao NA, Font RL: Plasmacytic conjunctivitis with crystalline inclusions: Immunohistochemical and ultrastructural studies . Arch Ophthalmol 1980;98:836-841.Crossref 15. Ormerod LD, Collin HB, Dohlman CH, et al: Paraproteinemic crystalline keratopathy . Ophthalmology 1988;95:202-212.Crossref 16. Theodore FH, Jakobiec FA, Juechter KB, et al: The diagnostic value of a ring infiltrate in acanthamoebic keratitis . Ophthalmology 1985;92:1471-1479.Crossref 17. Epstein DL, Paton D: Keratitis from misuse of corneal anesthetics . N Engl J Med 1968;279:396-399.Crossref 18. Smolin G, O'Connor GR: Immunologic reactions limited to the external eye , in Ocular Immunology . Philadelphia, Lea & Febiger, 1981, chap 4. 19. Yassa NH, Font RL, Fine BS, et al: Corneal immunoglobulin deposition in the posterior stroma: A case report including immunohistochemical and ultrastructural observations . Arch Ophthalmol 1987;105:99-103.Crossref 20. Fujikawa LS, Foster CS, Harrist TJ, et al: Fibronectin in healing rabbit corneal wounds . Lab Invest 1981;45:120-129.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Oct 1, 1988

References