Multimodal imaging of two cases of retinal vein occlusion secondary to Waldenstrom macroglobulinemia

Abstract

Purpose: To report multimodal imaging characteristics of two cases of retinal vein occlusion (RVO) secondary to Waldenstrom macroglobulinemia (WM). Case report: Case 1: An 82-year-old woman presented with vision loss. She had a history of WM. Best-corrected visual acuity (BCVA) was 20/100 Snellen equivalent in the right eye (OD) and 20/63 in the left eye (OS). Fundoscopy showed bilateral hemorrhages in posterior pole and along superotemporal arcade. Fluorescein angiography illustrated no macular leakage. Optical coherence tomography (OCT) revealed macular edema (ME). Optical coherence tomography angiography (OCTA) demonstrated abnormalities in choriocapillaris. A diagnosis of bilateral branch RVO was made and ME was treated with intravitreal dexamethasone, achieving stability. Case 2: A 65-year-old man presented with venous dilation, tortuosity, and intraretinal hemorrhages. BCVA was 20/20 in both eyes (OU). OCT showed ME and hyperreflective dots in choroid. A diagnosis of bilateral central RVO was made. Laboratory evaluation and bone narrow biopsy confirmed a diagnosis of WM. After that, our patient consulted because of vision loss. BCVA was 20/400 in OU. Fundoscopy and OCT demonstrated a worsening of the intraretinal hemorrhages and the ME. OCTA showed damage of choriocapillaris. Thus, intravitreal dexamethasone and plasmapheresis was advised. Two months after, BCVA was 20/40 in the OD and 20/32 in the OS. Also, fundoscopy and OCT improved. Conclusion: Early treatment of WM is truly important, with the aim of achieving a decrease in IgM levels in order to avoid toxic effect over the RPE that results in refractory ME.

Optical coherence tomography angiography features in Waldenström macroglobulinemia patients without Hyperviscosity syndrome.

“…[19][20][21] However, Sargues et al have previously detected morfological alterations of the super cial and deep plexuses on the OCTA evaluation of patients affected by WM disease, even in absence of HVS . 22 Informed consent Informed consent was obtained from all individual participants included in the study. Left eye (D-F) of a healty control patient (male, 68 years old) shows at multicolor imaging, a slight increasing tortuosity of retinal vessels (D), a normal vessel density in super cial and deep capillary plexus at OCTA (E-F).…”

Ultrasmall Coordination Polymer Nanodots Fe‐Quer Nanozymes for Preventing and Delaying the Development and Progression of Diabetic Retinopathy

“…It is a novel technique that has changed the understanding and knowledge of ophthalmologists. [ 33 ] Compared to fundoscopic findings, OCTA is noninvasive, provides rapid and safe access to high‐resolution fundus vascular imaging, does not require patients to dilate their pupils, and does not require the intravenous application of contrast. OCTA also allows clear visualization of capillary occlusion without problems with fluorescein leakage.…”