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Related Experiment Video

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Atypical Refractory Macular Edema: Are We Missing Something?

Chaitra Jayadev1, Ishank Gupta1, Santosh Gopi Krishna Gadde1

  • 1Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India.

Journal of Ophthalmic & Vision Research
|September 26, 2022
PubMed
Summary
This summary is machine-generated.

This case study highlights a diabetic patient with persistent macular edema. Effective treatment was achieved after diagnosing and managing an underlying multiple myeloma.

Keywords:
Multiple MyelomaParaproteinemic MaculopathySerous Macular DetachmentAtypical Macular Edema

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Area of Science:

  • Ophthalmology
  • Hematology
  • Internal Medicine

Background:

  • Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
  • Refractory DME poses a significant clinical challenge, often requiring investigation beyond conventional diabetes management.
  • Underlying systemic conditions can contribute to atypical or treatment-resistant ocular pathologies.

Observation:

  • A 65-year-old male with diabetes and hypertension presented with bilateral blurred vision and refractory macular edema.
  • Initial treatment with anti-VEGF and steroids for presumed DME yielded no improvement.
  • Further investigations revealed an underlying diagnosis of multiple myeloma.

Findings:

  • The patient's macular edema and subretinal fluid showed significant resolution after treatment for multiple myeloma.
  • This suggests a strong link between the hematologic malignancy and the refractory ocular condition.
  • Successful management of the systemic illness led to improved visual outcomes.

Implications:

  • This case underscores the importance of considering systemic diseases in patients with atypical or refractory macular edema.
  • Early diagnosis and management of underlying conditions like multiple myeloma can significantly improve visual prognosis in ophthalmology.
  • A multidisciplinary approach involving ophthalmologists and hematologists is crucial for complex cases of vision impairment.