Idiopathic bilateral lipid keratopathy

• Published in: British journal of ophthalmology Vol. 72; no. 5; pp. 338 - 343
• Main Authors: Alfonso, E., Arrellanes, L., Boruchoff, S. A., Ormerod, L. D., Albert, D. M.
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.05.1988; BMJ; BMJ Publishing Group LTD
• Subjects: Biological and medical sciences; Cholesterol - analysis; Cornea - ultrastructure; Corneal Diseases - metabolism; Corneal Diseases - pathology; Corneal Diseases - surgery; Corneal Opacity - etiology; Diseases of cornea, anterior segment and sclera; Fatty Acids, Nonesterified - analysis; Histiocytes - ultrastructure; Humans; Lipid Metabolism; Male; Medical sciences; Microscopy, Electron; Middle Aged; Ophthalmology; Phospholipids - analysis; Human; Pathology; Eye disease; Transmission electron microscopy; Idiopathic; Bilateral; Lipids; Keratopathy
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.72.5.338

A 52-year-old Mexican man presented with asymptomatic, bilaterally symmetrical lipid infiltrates of the cornea and adjacent limbus. No evidence of previous ocular disease or systemic disorder of lipid metabolism could be detected. Penetrating keratoplasty of the right eye was required. The cornea was rigid and thick, with posterior bulging into the anterior chamber. Light microscopy revealed deep corneal lipid granules, foamy histiocytes, vascularisation, and chronic non-granulomatous inflammation. Transmission electron microscopy showed extracellular lipid spaces and numerous intracytoplasmic lipid vacuoles in histiocytes, keratocytes, conjunctival epithelium, and the endothelium of blood vessels in the corneal stroma and adjacent limbal conjunctiva. Histochemical analysis revealed the presence of neutral fats, free fatty acids, cholesterol, and phospholipids.