Hyperviscosity retinopathy secondary to polyclonal gammopathy in a patient with rheumatoid arthritis

A patient with rheumatoid arthritis developed retinal venous stasis as part of a hyperviscosity syndrome secondary to a polyclonal gammopathy. Ocular findings included bilateral retinal venous dilation, disc hyperemia, optociliary venous collaterals, and left macular edema. This clinical picture improved following systemic corticosteroid therapy. Although occasional cases of rheumatoid polyclonal gammopathy causing hyperviscosity have been described in the rheumatology literature, this case represents the first detailed ophthalmological documentation of this occurrence.