Serous macular detachment, yellow macular deposits, and prominent middle limiting membrane in multiple myeloma

Bone marrow-derived multiple myeloma is a type of plasma cell tumor that may be associated with ocular complications. A 52-year-old male patient was admitted to our eye clinic with the complaint of sudden visual loss and a visual acuity of 20/50 in the right eye and 20/800 in the left eye. Fundus examination revealed common flame-shaped hemorrhages, venous dilatation and tortuosity, Roth spots, serous macular detachment, and yellow macular deposits in both eyes. Evaluation with fundus fluorescein angiography, fundus autofluorescence, and spectral-domain optical coherence tomography resulted in suspicion of hyperviscosity retinopathy and referral to the hematology clinic. After hematology consultation confirmed a diagnosis of multiple myeloma, chemotherapy and plasmapheresis were initiated. Four months after presentation, best-corrected visual acuity was 20/20 in both eyes and improvement in hyperviscosity retinopathy, serous macular detachment, and yellow macular deposits was observed.

[1]  Michael D. Ober,et al.  Immunogammopathies and acquired vitelliform detachments: a report of four cases. , 2014, American journal of ophthalmology.

[2]  S. Byeon,et al.  IN VIVO DETECTION OF ACUTE ISCHEMIC DAMAGES IN RETINAL ARTERIAL OCCLUSION WITH OPTICAL COHERENCE TOMOGRAPHY: A “Prominent Middle Limiting Membrane Sign” , 2013, Retina.

[3]  Gary C. Brown,et al.  Serous macular detachment in Waldenström macroglobulinemia: a report of four cases. , 2013, American journal of ophthalmology.

[4]  S. Grover,et al.  Spectral-domain optical coherence tomography of Roth spots in multiple myeloma , 2012, Eye.

[5]  L. Yannuzzi,et al.  ACQUIRED VITELLIFORM LESIONS: Correlation of Clinical Findings and Multiple Imaging Analyses , 2011, Retina.

[6]  N. Lois,et al.  Bilateral ‘vitelliform-like’ macular lesions in a patient with multiple myeloma , 2010, BMJ Case Reports.

[7]  A. Erginay,et al.  Subfoveal deposits secondary to idiopathic epiretinal membranes. , 2009, Ophthalmology.

[8]  S. Singhal,et al.  Hyperviscosity syndrome in plasma cell dyscrasias. , 2003, Seminars in thrombosis and hemostasis.

[9]  A. Ho,et al.  Unusual immunogammopathy maculopathy. , 2000, Ophthalmology.

[10]  P. Henkind,et al.  Multiple myeloma and its ocular manifestations. , 1987, Survey of ophthalmology.

[11]  A. Kroll.  Experimental central retinal artery occlusion. , 1968, Archives of ophthalmology.

[12]  R. Carr,et al.  RETINAL FINDINGS ASSOCIATED WITH SERUM HYPERVISCOSITY. , 1963, American journal of ophthalmology.

[13]  B. S. Fine,et al.  Muller's cells and the "middle limiting membrane" of the human retina. An electron microscopic study. , 1962, Investigative ophthalmology.