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Sequential central retinal artery occlusions associated with cryoglobulinemia.

Patrick Wang¹, Pushpinder Kanda², Yao Wang³

¹Department of Ophthalmology, Queen's University, Kingston, ON, Canada.

International Journal of Retina and Vitreous

|March 23, 2023

Summary

This case study details a patient with cryoglobulinemia who experienced sequential central retinal artery occlusion (CRAO). It highlights the importance of considering cryoglobulinemia in patients with a history of malignancy or hepatitis presenting with vision loss.

Keywords:

Central retinal artery occlusion Cryoglobulinemia Mixed cryoglobulinemia

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Retinal Cryo-sections, Whole-Mounts, and Hypotonic Isolated Vasculature Preparations for Immunohistochemical Visualization of Microvascular Pericytes

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Published on: October 7, 2018

Area of Science:

Ophthalmology
Hematology
Rheumatology

Background:

Cryoglobulinemia, characterized by immunoglobulins precipitating below 37°C, typically presents with skin issues but rarely affects the eyes.
This is the first reported case of sequential central retinal artery occlusion (CRAO) associated with cryoglobulinemia.

Purpose of the Study:

To report the first case of sequential central retinal artery occlusion (CRAO) in a patient with cryoglobulinemia.
To emphasize the potential link between cryoglobulinemia and CRAO, particularly in at-risk individuals.

Main Methods:

A 69-year-old female with a history of B-cell lymphoma and cryoglobulinemia presented with acute vision loss in the right eye.
Laboratory findings included a high cryocrit (55%), elevated IgG and IgM cryoglobulin levels, and increased kappa free light chains.
The patient received treatment with intravenous methylprednisone, rituximab, and bendamustine chemotherapy.

Main Results:

The patient experienced sequential CRAO, with the right eye affected after the left.
Elevated cryoglobulin levels raised suspicion for cryoglobulinemia-associated CRAO.

Conclusions:

The case highlights a potential association between cryoglobulinemia and sequential CRAO.
Considering cryoglobulinemia is crucial for patients with a history of hematological malignancy or chronic hepatitis presenting with vision loss.