Hyperviscosity retinopathy as the initial presentation of aggressive multiple myeloma

Area of Science:

• Ophthalmology
• Hematology
• Oncology

Background:

• Multiple myeloma (MM) is a plasma cell malignancy.
• Neoplastic plasma cell proliferation causes monoclonal immunoglobulin overproduction.
• This can lead to hyperviscosity retinopathy, a serious complication.

Observation:

• A 56-year-old male presented with a month of progressive, painless vision loss.
• Ophthalmic examination revealed hyperviscosity retinopathy.
• The presentation mimicked bilateral central retinal vein occlusion.

Findings:

• Hematologic assessment confirmed immunoglobulin A multiple myeloma.
• Despite chemotherapy and stem cell transplant, the patient succumbed to the disease.
• This case underscores the aggressive nature of MM in some patients.

Implications:

• Ophthalmic manifestations can be the initial presentation of multiple myeloma.
• Prompt recognition of hyperviscosity retinopathy is crucial.
• Early referral to an oncologist can facilitate timely diagnosis and management, potentially improving outcomes.