Bilateral Simultaneous Central Retinal Vein Occlusion in a Patient with Waldenstrom's Macroglobulinemia.
10.3341/jkos.2016.57.6.1012
- Author:
Sang Eon LEE
1
;
Yong Un SHIN
;
Han Woong LIM
;
Min Chul SEONG
;
Hee Yoon CHO
;
Min Ho KANG
Author Information
1. Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. ocularimmunity@gmail.com
- Publication Type:Case Report
- Keywords:
Central retinal vein occlusion;
Waldenstrom's macroglobulinemia
- MeSH:
Aged;
Anemia;
Bevacizumab;
Biopsy;
Bone Marrow;
Dexamethasone;
Drug Therapy;
Epistaxis;
Humans;
Hypertension;
Lymphoma;
Macular Edema;
Retinal Hemorrhage;
Retinal Vein*;
Veins;
Visual Acuity;
Waldenstrom Macroglobulinemia*
- From:Journal of the Korean Ophthalmological Society
2016;57(6):1012-1017
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The authors report a case of bilateral simultaneous central retinal vein occlusion caused by Waldenstrom's macroglobulinemia. CASE SUMMARY: A 65-year-old man presented to our department complaining of decreased visual acuity for the duration of about 6 months. On his initial visit, best-corrected visual acuity was 0.02 in the right eye and 0.06 in the left eye. Based on the findings of a funduscopic examination, the patient had bilateral diffuse retinal hemorrhages, dilated tortuous veins, and macular edema. He had experienced recurrent spontaneous epistaxis 6 months previously and had undergone treatments such as intravitreal bevacizumab injection and intravitreal dexamethasone implantation at another hospital. Laboratory tests at that hospital showed anemia and hyperproteinemia, for which he was referred to our hemato-oncology department. Bone marrow biopsy was consistent with Waldenstrom's macroglobulinemia/lymphoplasmacytoid lymphoma, and he was treated with systemic chemotherapy. One year after the systemic chemotherapy, his best-corrected visual acuity was 0.15 in the right eye and 0.6 in the left eye. Funduscopy showed decreased bilateral retinal hemorrhages and macular edema. CONCLUSIONS: When simultaneous bilateral central retinal vein occlusion occurs in a patient with no other underlying disease such as hypertension or diabetes, it might be a sign of serum hyperviscosity, and there should be a very high level of suspicion for presence or progression of systemic disease. If such a disease is properly and timely diagnosed, effective early systemic evaluation and therapy can be administered, and it is important to have initial general treatment as well as ophthalmic treatment.
