Case Report

Unilateral Idiopathic Lipid Crystalline Keratopathy: A Clinicopathological Report

Abstract

- Lipid keratopathy refers to corneal lipid infiltrations. We report a 54-year-old female without any systemic disorder presented with a slowly progressive yellow-white infiltrate in the inferotemporal part of the left cornea for six years. Due to a visual axis involvement leading to decreased visual acuity, the patient underwent penetrating keratoplasty on the left eye. The excised corneal button specimen was sent for pathological evaluation. Anterior segment optical coherence tomography (AS-OCT) and confocal scanning microscopy showed an intra-stromal hyper-reflective material consistent with lipid crystalline keratopathy diagnosis. Histopathology revealed an excessive amount of fat droplets in corneal stroma presented as clear areas in hematoxylin and eosin (H & E) staining in keeping with Oil Red O staining. Idiopathic lipid crystalline keratopathy is a diagnosis of exclusion. For such a diagnosis, the serum lipid profile should be checked to rule out fat metabolic disorders and ocular diseases causing chronic inflammation leading to secondary corneal lipid depositions.

1. Alfonso E, Arrellanes L, Boruchoff SA, Ormerod LD, Albert DM. Idiopathic bilateral lipid keratopathy. Br J Ophthalmol 1988;72:338-43.
2. Ghazal W, Georgeon C, Grieve K, Bouheraoua N, Borderie V. Multimodal Imaging Features of Schnyder Corneal Dystrophy. J Ophthalmol 2020;2020:6701816.
3. Lock JH, Ross CA, Flaherty M. Corneal arcus as the presenting sign of familial hypercholesterolemia in a young child. J AAPOS 2018;22:467-8.
4. Pang Y, Zhan Q, Bao Y. A CARE-compliant article: ipsilateral progressive idiopathic lipid keratopathy: A case report. Medicine (Baltimore) 2019;98:e16589.
5. Baum JL. Cholesterol keratopathy. Am J Ophthalmol 1969;67:372-5.
6. Barishak YR, Stein R. Lipid keratopathy. Ann Ophthalmol 1974;6:377-80.
7. Loeffler KU, Seifert P. Unusual idiopathic lipid keratopathy: a newly recognized entity? Arch Ophthalmol 2005;123:1435-8.
8. Levy J, Benharroch D, Lifshitz T. Bilateral severe progressive idiopathic lipid keratopathy. Int Ophthalmol 2005;26:181-4.
9. Ghanem RC, Ghanem VC, Victo G, Alves MR. Bilateral Progressive Idiopathic Annular Lipid Keratopathy. Case Rep Ophthalmol Med 2012;2012:1-4.
10. Cogan DG, Kuwabara T. Lipid keratopathy and atheroma. Trans Am Ophthalmol Soc 1958;56:109-22.
Files
IssueVol 59, No 4 (2021) QRcode
SectionCase Report(s)
Published2021-05-18
DOI https://doi.org/10.18502/acta.v59i4.6222
Keywords
Lipid keratopathy Cornea Crystalline keratopathy Clinicopathological

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hasani H, Zand A. Unilateral Idiopathic Lipid Crystalline Keratopathy: A Clinicopathological Report. Acta Med Iran. 59(4):228-231.