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Letter to the Editor
Primary epithelial amyloid keratopathy with multiple recurrences in grafts
  1. TAMARA WYGNANSKI-JAFFE,
  2. ISAAC AVNI,
  3. IGOR BRIKMAN,
  4. MORDECHAI ROSNER
  1. Goldschleger Eye Institute
  2. Sackler School of Medicine, Tel Aviv University
  3. Sheba Medical Center, Tel Hashomer, Israel
  1. Mordechai Rosner, MD.

https://doi.org/10.1136/bjo.82.3.e326

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    Editor,—Primary epithelial amyloid keratopathy (PEAK) is a newly described entity of subepithelial amyloidosis. PEAK is an aggressive variant of primary gelatinous drop-like dystrophy in patients of eastern origin. We describe the clinical and histopathological findings of two brothers suffering from PEAK. The opacities recurred in one after epithelial scrapping and in the other after repeated penetrating keratoplasty.

    CASE REPORTS

    Two patients of Iranian origin were treated in our department. Light microscopy, histochemistry, and electron microscopy were performed on epithelial scrapping, corneal buttons, and failed grafts.

    Clinically, the two brothers presented with deterioration of vision, photophobia, and redness. Examination revealed corneal opacification of the central cornea, which also occurred in the grafts. Histopathological examination disclosed intraepithelial and stromal deposits of amyloid associated with inflammation.

    The elder brother, now a 50 year old, has been suffering from visual disturbances and photophobia in both …

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