ENHANCED DEPTH IMAGING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FEATURES OF LIGHT CHAIN DEPOSITION DISEASE

To describe a previously unreported finding in the choroid of a patient with light chain deposition disease on enhanced depth imaging optical coherence tomography.

Clinical examination, fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral domain enhanced depth imaging optical coherence tomography were performed in a patient with light chain deposition disease.

This 45-year-old white man presented with decreased vision in both eyes. Clinical examination and color fundus photography revealed multiple ill-defined deep yellow lesions in the macula and periphery with granular retinal pigment epithelium changes in the macula of both eyes. The yellow lesions displayed increased autofluorescence, hyperfluorescence on fluorescein angiography, and hypocyanescence on indocyanine green angiography. Spectral domain enhanced depth imaging optical coherence tomography demonstrated irregularities of the outer retina, choroidal thickening with dilated outer choroidal vessels, and near-confluent hyperreflectivity of the choriocapillaris.

Patients with light chain deposition disease may have characteristic findings on spectral domain enhanced depth imaging optical coherence tomography that corroborate previously reported histopathologic findings in light chain deposition disease. This rare disease should be considered in the differential diagnosis for infiltrative choroidopathies.