Serous retinal detachments associated with light chain deposition disease

To report the clinical, fluorescein angiography, spectral-domain optical coherence tomography, and fundus autofluorescence (AF) findings of a 64-year-old woman with systemic light chain deposition disease.

Clinical examination, fundus photographs, fundus AF, spectral-domain optical coherence tomography, and fluorescein angiography before and after renal transplantation in a patient with light chain deposition disease.

The patient presented with decreased visual acuity in her right eye. Fundus examination showed bilateral drusenoid subretinal deposits associated with subretinal fluid. Fluorescein angiography showed staining of the lesions seen on clinical examination. Spectral-domain optical coherence tomography showed hyperreflective material below the neurosensory retina associated with subretinal fluid. Fundus AF showed areas of increased AF corresponding to the lesions. The lesions showed improvement after renal transplantation and initiation of immunosuppressive agents.

Patients with light chain deposition disease may present with subretinal deposits that can be seen clinically and demonstrated on fluorescein angiography, AF, and optical coherence tomography. They may also present with localized serious retinal detachments. Both these deposits and serous retinal detachments may improve with renal transplantation or immunosuppressive therapy.