Eyelids & the Anterior Segment:
                        Case thirty two

This is the corneal histology of a 45 year-old man who had had a penetrating keratoplasty.

a. What does the picture show?

Multiple yellowish green deposits within the stroma.
The cornea was stained with Congo red and viewed through crossed polarizing filters.

b. What is the diagnosis?

Lattice dystrophy.
The abnormal material within the stroma is made up of amyloid.
c. What are the different types of this condition?
Three types of lattice dystrophy are recognized:
  • Type 1: the classical type which is inherited in an autosomal dominant fashion. The amyloid is made up of AA amyloid.
  • Type 2: this is associated with systemic amyloidosis and is classically seen in Meretoja's syndrome (blepharochalasis, bilateral facial nerve palsies, peripheral neuropathy and systemic amyloidosis)
  • Type 3: this is made up of AP amyloid and the condition is inherited in an autosomal recessive fashion.
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