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Unusual immunogammopathy maculopathy
1Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Purpose:
To describe an unusual maculopathy in patients with serum immunogammopathies.
Design:
Retrospective observational small case series.
Participants:
Three patients derived from the clinical retina practices of the authors were noted to have unusual maculopathy.
Methods:
Each patient underwent fluorescein angiography and serum laboratory evaluation.
Main Outcome Measure:
Findings on fluorescein angiography.
Results:
An unusual and atypical macular detachment with or without subretinal precipitates or fundus signs of serum hyperviscosity, such as retinal hemorrhages and dilated retinal veins, may be observed in patients with immunogammopathies such as multiple myeloma, Waldenström's macroglobulinemia, and benign polyclonal gammopathy. Fluorescein angiography shows macular hypofluorescence with no evidence of retinal vascular or retinal pigment epithelial leakage within the macular elevation.
Conclusions:
Patients with atypical unilateral or bilateral macular detachment may be afflicted with a serum immunogammopathy such as multiple myeloma or Waldenström's macroglobulinemia. Diagnostic serum protein electrophoresis and hematology consultation should be considered.
