Corneal copper deposition associated with chronic lymphocytic leukemia.

PURPOSE: To report a case of corneal copper deposition associated with chronic lymphocytic leukemia (CLL).

DESIGN

Case report.

METHODS

A 65-year-old woman with a history of CLL was diagnosed with bilateral corneal opacification. Slit-lamp examination revealed dense, central yellow-brown pigmentation of Descemet's membrane in each cornea. The presence of a bilateral pigmented deposition at the level of Descemet's membrane led to a presumptive clinical diagnosis of corneal copper deposition.

RESULTS

Serologic investigations revealed a markedly elevated copper (hypercupremia) and IgG levels with a normal ceruloplasmin. Wilson's disease was excluded as a possible cause based on liver function tests and a liver biopsy. Thus, the patient was diagnosed with corneal copper deposition secondary to hypercupremia associated with CLL.

CONCLUSIONS

Corneal copper deposition may be associated with systemic malignancy, most commonly myeloproliferative disorders, including CLL. Recognition of the characteristic clinical features associated with corneal copper deposition allows the clinician to confirm the diagnosis with appropriate serologic studies.