Hyperviscosity Retinopathy and Immunogammopathy Maculopahy as New Onset of Multiple Myeloma

The purpose is to report a case of immunogammopathy maculopathy and hyperviscosity retinopathy as the presenting feature of new-onset multiple myeloma (MM) in an otherwise healthy man. A 50-years-old man presented with painless visual changes in both eyes for 2 months. Ocular examination revealed bi...

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Bibliographic Details
Published in:Case reports in ophthalmology 2021-07, Vol.12 (2), p.578-584
Main Authors: Ferreira Santos da Cruz, Natasha, Milhomens Filho, José Arthur Pinto, Ferraro, Desirée Mayara Nery, Polizelli, Murilo Ubukata, de Moraes Ambrogini, Nilva Simeren Bueno
Format: Article
Language:English
Subjects:
blood viscosity
Bone marrow
Case Report
Case reports
Chemotherapy
Cysts
Edema
Hypercalcemia
immunogammopathy maculopathy
Immunoglobulins
macular edema
Medical imaging
Multiple myeloma
Pathogenesis
Patients
Photoreceptors
Proteins
Retina
Transplants & implants
triamcinolone
Viscosity
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Summary:The purpose is to report a case of immunogammopathy maculopathy and hyperviscosity retinopathy as the presenting feature of new-onset multiple myeloma (MM) in an otherwise healthy man. A 50-years-old man presented with painless visual changes in both eyes for 2 months. Ocular examination revealed bilateral CRVO-like associated with macular edema (ME) and an inferior serous detachment. Hematologic investigation revealed an increased percentage of plasma cells in the bone marrow, reaching the diagnosis of MM IgM/kappa. Clinical support and chemotherapy effectively improved ocular alterations, despite the residual ME. Injection of triamcinolone was carried out, without any response. Bilateral vision reduction with hyperviscosity syndrome-related retinopathy and immunogammopathy maculopathy was the first manifestation of an underlying systemic and potentially fatal disease. This case highlights the need for diligent and thorough investigations for less common systemic conditions associated with retinal vein occlusions.
ISSN:1663-2699
1663-2699
DOI:10.1159/000514695