Bilateral Gelatinous Drop-like Corneal Dystrophy: Outcomes of Sequential Keratoplasty

Bilateral Gelatinous Drop-like Corneal Dystrophy: Outcomes of Sequential Keratoplasty | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Bilateral Gelatinous Drop-like Corneal Dystrophy: Outcomes of Sequential Keratoplasty Mohammad Abusayf, Rana Alhumaemydi, Abeer Alkhodair, Majed Alkharashi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6514948/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: Gelatinous drop-like corneal dystrophy (GDLD) is a rare autosomal recessive condition characterized by amyloid deposition in the corneal epithelium and stroma, leading to progressive vision loss. This report aims to present a case of GDLD in a young female, highlighting the clinical course, histopathological findings, and surgical outcomes over the course of 2 years. Case Summary: A 21-year-old female presented with reduced visual acuity in the left eye and a positive family history of vision related issues. She had undergone penetrating keratoplasty (PKP) in the right eye one year earlier at another institution. Examination revealed a clear graft in the right eye with no rejection and diffuse, dense, white opacification with stromal haze in the left eye. Visual acuity (VA) was 20/100 in the right eye and counting fingers near face in the left eye. Given the advanced disease in the left eye, the patient underwent PKP, with successful surgical outcomes. Histopathological analysis of the excised corneal tissue revealed subepithelial amyloid deposits staining positively with Congo red and birefringent under polarized light, confirming GDLD. Postoperatively, the patient demonstrated stable vision and clear grafts in both eyes. Conclusion: GDLD is a challenging condition due to its progressive nature and recurrence post-surgery. This case highlights the importance of histopathological confirmation and tailored surgical management. The successful surgical and postoperative outcomes in this patient highlight the role of keratoplasty in restoring corneal clarity and importance of early interventions to prevent amblyopia. Keywords: Gelatinous drop-like corneal dystrophy, penetrating keratoplasty, corneal dystrophy, subepithelial amyloid deposits, TACSTD2. Declaration of conflict of interest: The authors declare no conflict of interest. Funding sources: None Gelatinous drop-like corneal dystrophy penetrating keratoplasty corneal dystrophy subepithelial amyloid deposits TACSTD2 Full Text Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6514948","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":452881747,"identity":"53f43684-5c36-436f-b4ee-b79933ade15c","order_by":0,"name":"Mohammad Abusayf","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"","lastName":"Abusayf","suffix":""},{"id":452881748,"identity":"bf9e4939-8a2e-4b0a-8cf2-d9f71ffca582","order_by":1,"name":"Rana Alhumaemydi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDElEQVRIiWNgGAWjYPACiwQog5mHH0QlFBDUIoHQItkA0mJAghYGgwMgGo8W8/azBz8w1EjkGVw7fPDTzTZrGePzqxM/PDBgkOcXO4BVi8yZvGQJhmMSxQa305Klc9vSecxuvN0sAXSY4czZCVi1SDDkGEgwsEkkbridYwDUchio5ewGkJYEg9s4tPC/Mf7B8A+kJf/zb5AW4xlnN//Aq0Uix0yCsQ1sCxvYFgP+3m34bZF4Y2aR2CeROPN2mpl1zrl0HokbvNssEgwkcPuFP8f4xodvNol9t5Mf384ps7bn7z+7+eaPCht5fmnsWsAALsXIxgCLIwncylHBHyDmP0Cs6lEwCkbBKBghAACc1V5AzxCA2wAAAABJRU5ErkJggg==","orcid":"","institution":"King Saud University","correspondingAuthor":true,"prefix":"","firstName":"Rana","middleName":"","lastName":"Alhumaemydi","suffix":""},{"id":452881749,"identity":"1e78881c-4323-44d7-8bfa-420e1e3f40ae","order_by":2,"name":"Abeer Alkhodair","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Abeer","middleName":"","lastName":"Alkhodair","suffix":""},{"id":452881750,"identity":"9cc2da82-cc83-49bd-b2e0-3c7e63d0c974","order_by":3,"name":"Majed Alkharashi","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Majed","middleName":"","lastName":"Alkharashi","suffix":""}],"badges":[],"createdAt":"2025-04-23 18:23:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6514948/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6514948/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83389029,"identity":"3dd09bd4-5d60-48e9-ba60-96143109fbb2","added_by":"auto","created_at":"2025-05-24 15:16:54","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":450253,"visible":true,"origin":"","legend":"","description":"","filename":"FinalBilateralGelatinousCornealDystrophyMohammedAbusayf17APRIL.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6514948/v1_covered_9ca4a484-8c30-43b1-8c48-0a828b136e96.pdf"},{"id":82137802,"identity":"25830b8f-fe17-4840-bad1-6a016c4485bb","added_by":"auto","created_at":"2025-05-07 06:20:35","extension":"mp4","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":33435177,"visible":true,"origin":"","legend":"","description":"","filename":"gld.mp4","url":"https://assets-eu.researchsquare.com/files/rs-6514948/v1/132c41279b0f211c0a764e86.mp4"}],"financialInterests":"No competing interests reported.","formattedTitle":"Bilateral Gelatinous Drop-like Corneal Dystrophy: Outcomes of Sequential Keratoplasty","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Gelatinous drop-like corneal dystrophy, penetrating keratoplasty, corneal dystrophy, subepithelial amyloid deposits, TACSTD2","lastPublishedDoi":"10.21203/rs.3.rs-6514948/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6514948/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e Gelatinous drop-like corneal dystrophy (GDLD) is a rare autosomal recessive condition characterized by amyloid deposition in the corneal epithelium and stroma, leading to progressive vision loss. This report aims to present a case of GDLD in a young female, highlighting the clinical course, histopathological findings, and surgical outcomes over the course of 2 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Summary:\u003c/strong\u003e A 21-year-old female presented with reduced visual acuity in the left eye and a positive family history of vision related issues. She had undergone penetrating keratoplasty (PKP) in the right eye one year earlier at another institution. Examination revealed a clear graft in the right eye with no rejection and diffuse, dense, white opacification with stromal haze in the left eye. Visual acuity (VA) was 20/100 in the right eye and counting fingers near face in the left eye. Given the advanced disease in the left eye, the patient underwent PKP, with successful surgical outcomes. Histopathological analysis of the excised corneal tissue revealed subepithelial amyloid deposits staining positively with Congo red and birefringent under polarized light, confirming GDLD. Postoperatively, the patient demonstrated stable vision and clear grafts in both eyes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e GDLD is a challenging condition due to its progressive nature and recurrence post-surgery. This case highlights the importance of histopathological confirmation and tailored surgical management. The successful surgical and postoperative outcomes in this patient highlight the role of keratoplasty in restoring corneal clarity and importance of early interventions to prevent amblyopia. Keywords: Gelatinous drop-like corneal dystrophy, penetrating keratoplasty, corneal dystrophy, subepithelial amyloid deposits, TACSTD2. Declaration of conflict of interest: The authors declare no conflict of interest. \u0026nbsp;Funding sources: None \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Bilateral Gelatinous Drop-like Corneal Dystrophy: Outcomes of Sequential Keratoplasty","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-07 06:20:29","doi":"10.21203/rs.3.rs-6514948/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4b82932b-a6ba-4865-b53e-f345e41207c4","owner":[],"postedDate":"May 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-24T15:08:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-07 06:20:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6514948","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6514948","identity":"rs-6514948","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}