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Bilateral optic neuropathy associated with multiple myeloma.

Yoshiaki Shimada1, Masayuki Shibuya, Ryutaro Ohki

  • 1Department of Ophthalmology, Saitama Medical School, Iruma, Saitama, Japan. ysmd@za2.so-net.ne.jp

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|July 18, 2006
PubMed
Summary

Multiple myeloma can cause vision loss and optic disc swelling. This case showed spontaneous visual improvement before treatment, suggesting unknown mechanisms beyond tumor compression.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Hematology

Background:

  • Multiple myeloma (MM) is a plasma cell malignancy.
  • Optic neuropathy can be a rare presenting symptom of MM.
  • Typical causes include direct tumor infiltration or compression.

Observation:

  • A 51-year-old man presented with reduced vision and bilateral optic disc swelling.
  • Brain imaging revealed no abnormalities.
  • Spontaneous visual improvement occurred before initiating therapy.

Findings:

  • Visual function and optic disc appearance normalized near-completely after chemotherapy.
  • The patient lacked features of POEMS syndrome.
  • The exact mechanism of optic neuropathy in this case remains undetermined.

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Implications:

  • This case highlights an unusual presentation of multiple myeloma.
  • It suggests potential non-compressive/infiltrative mechanisms for myeloma-associated optic neuropathy.
  • Further research is needed to elucidate the pathophysiology of such visual disturbances.