Lipid keratopathy - Lipid deposition and serum cholesterol level

Light and electron microscopy were used to examine yellow-white opacities around the area of abnormal corneal stromal vascularization from the limbus in 2 patients with hypercholesterolemia. Intracellular lipid droplets were noted in keratocytes near capillaries, and needle-shaped crystals of cholesterol were seen extracellularly, evidence that the opacities resulted from deposition of lipid in the stroma. On the basis of clinical findings in these 2 patients, we hypothesized that accumulation of lipid was responsible for 19 opacities in 32 patients with abnormal corneal stromal vessels. Correlations were found between lipid deposition and serum cholesterol levels in these patients, suggesting that hypercholesterolemia (>200 mg total cholesterol/dl) and abnormal corneal vascularization place a patient at high risk of developing lipid keratopathy (LK). In the early stage of LK, ablation of vascular channels or normalization of serum cholesterol levels could prevent progression of lipid deposition and helped lipid infiltrate to resolve. In this way, early treatment can be effective in preventing the occurrence of LK itself or progression of opacity.