 |
Case Report
Use of topical steroids in the setting of corneal subepithelial deposits due to multiple myeloma
1 Department of Ophthalmology, Cornea and External Diseases, Massachusetts Eye and Ear, Harvard University Medical School, Boston, Massachusetts 02114, USA
2 Department of Ophthalmology, Comprehensive Ophthalmology, Massachusetts Eye and Ear, Harvard University Medical School, Boston, Massachusetts 02114, USA
Address correspondence to:
Emma Davies
MD, Mass Eye and Ear, 243 Charles St, Boston, MA 02114,
USA
Message to Corresponding Author
Article ID: 100043Z17DK2024
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Akrobetu D, Lorch A, Davies E. Use of topical steroids in the setting of corneal subepithelial deposits due to multiple myeloma. J Case Rep Images Opthalmol 2024;7(2):9–12.ABSTRACT
Introduction: The aim of this case report was to describe the use of topical steroids in a patient with subepithelial corneal deposits most likely due to multiple myeloma.
Case Report: A 58-year-old white female with multiple myeloma was referred to a cornea sub-specialty clinic at Massachusetts Eye and Ear for intermittent blurred vision and development of peripheral corneal deposits in both eyes. On examination, bilateral, superior peripheral corneal deposits were identified with an otherwise clear cornea. There was no corneal neovascularization, epithelial defect, or stromal gelatinous changes. The anterior chamber was quiet without any cell or flare. Dilated fundus examination was unremarkable. The corneal deposits did not resemble nodules found in Salzmann nodular degeneration or pannus from ocular rosacea/contact lens wear/trauma. Given that the patient had no prior history of eye problems or trauma, it was believed that the corneal subepithelial deposits were inflammatory changes due to her relatively recent (within one year) diagnosis of multiple myeloma. The patient was started on loteprednol etabonate 0.5% ophthalmic suspension one drop two times daily in both eyes and one month follow-up was arranged. At her one-month visit, the corneal deposits were much improved and, subsequently, her loteprednol drops were reduced to one drop nightly in both eyes for two months followed by 1 drop Monday/Wednesday/Friday in both eyes for two months.
Conclusion: We describe an interesting case in which low dose topical steroid was utilized and may have contributed toward the stabilization and regression of peripheral subepithelial corneal deposits most likely due to multiple myeloma. It is possible that some of the observed improvement in the patient’s corneal deposits were in part due to her systemic treatment of multiple myeloma. Further studies are needed to establish the impact of topical steroids in this patient population, especially in more severely affected eyes.
Keywords: Corneal deposits, Multiple myeloma, Subepithelial deposits, Topical steroids
SUPPORTING INFORMATION
Author Contributions
Dennis Akrobetu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alice Lorch - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Emma Davies - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Dennis Akrobetu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
