Multiple Myeloma Presenting as Recalcitrant Macular Edema

Area of Science:

• Ophthalmology
• Hematology
• Oncology

Background:

• Multiple myeloma, a plasma cell dyscrasia, can present with ocular manifestations.
• Ocular involvement in multiple myeloma is rare but can mimic common retinal diseases.

Observation:

• A case of multiple myeloma presenting with ocular symptoms mimicking diabetic macular edema.
• Diagnostic challenges arose due to coexisting type 2 diabetes and retinal hemorrhages.
• Key features included vitreous opacities and significant weight loss, suggesting a neoplastic process.

Findings:

• Multimodal imaging revealed characteristic findings associated with plasma cell dyscrasias.
• The study elucidates the mechanism by which plasma cell dyscrasias induce macular edema and exudative retinal detachments.
• The case highlights the diagnostic difficulty posed by concurrent ocular conditions.

Implications:

• Ocular findings can be an early indicator of multiple myeloma and related plasma cell dyscrasias.
• Consideration of multiple myeloma in the differential diagnosis of recalcitrant macular edema is essential.
• Prompt systemic evaluation is recommended for suspected cases to ensure timely diagnosis and treatment.