Prominent Corneal Nerves Revealing Of Smoldering Multiple Myeloma : A Case Report.
Published 2024 - 42nd Congress of the ESCRS
Reference: PO949 | Type: Poster | DOI: 10.82333/ya9r-0479
Authors: Soukaina Laaouina* 1 , houda brarou 1 , soundouss sebbata 1 , Adil Elkhouyaali 1 , Aissam Fiqhi 1 , Yassine mouzari 1 , abdelbarre oubaaz 1
1ophthalmology,military hospital of instruction Mohammed V,Rabat ,Morocco
Purpose
To describe a case of prominent corneal nerves observed in a patient, what led us to the diagnosis of smoldering multiple myeloma.
Setting
Corneal nerve hypertrophy is a rare condition that can occur in several health conditions.
We report the case of a 55-year-old patient who presented for cataract surgery, and in whom the ophthalmological examination showed the presence of prominent corneal nerves in both eyes. The etiological assessment revealed a Smoldering Multiple Myeloma (SMM).
Methods
We report the case of a 55-year-old patient with no particular history, who presented for cataract surgery in the right eye.
Results
Corneal examination of both eyes was characterized by linear, stromal opacities, starting from the limb to the center of the cornea. The rest of the ophthalmological examination was unremarkable.
The optical coherence tomography of the anterior segment of both eyes showed a corneal thickness of 495 um in the center. The nerves appear to be hyperreflective lines at the stromal level.
Serum protein electrophoresis revealed a raised serum kappa paraprotein band. The erythrocyte sedimentation rate was accelerated. Renal assessment, calcemia, and hemoglobin rate were normal.
Bone marrow biopsy was performed, showing 30% plasma cells The patient was diagnosed as having SMM, and was referred to hematology for management.
Conclusions
Certain diseases, such as multiple myeloma, multiple endocrine neoplasia (MEN) type 1 and type 2A and 2B, congenital ichthyosis, Refsum’s disease, leprosy, etc., have been associated with the presence of prominent corneal nerves. Therefore, it is important to carry out a thorough evaluation even in the absence of general symptoms, as this can help in the early detection and management of such diseases.