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RETINAL VASCULAR DISEASES

Ocular Manifestations of Waldenstrom Macroglobulinemia

Ocular Manifestations of Waldenstrom Macroglobulinemia - Start  
Ocular Manifestations of Waldenstrom Macroglobulinemia - End  

Waldenstrom Macroglobulinemia (WM) is a chronic, indolent, lymphoproliferative disorder, characterized by the presence of a high level of a macroglobulin (immunoglobulin M [IgM]), elevated serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. The cancer cells in patients with WM are similar to those of two other types of cancer: multiple myeloma and non-Hodgkin lymphoma.

One of the complications of WM is the hyperviscosity syndrome and secondary visual disturbances. Retinal manifestations include slight dilation and fullness of veins, hemorrhages, exudates, occlusion of the central retinal vein, retinal edema, and exudative retinal detachment. Patients may complain of blurred vision or blind spots. 

The median age at diagnosis is 68 years and it is twice as frequent in men. Diagnosis is confirmed by the presence of an IgM monoclonal protein in the serum and a bone marrow biopsy.

Differential Diagnosis:

  • Multiple myeloma
  • Chronic lymphocytic leukemia
  • Lymphoma, non-Hodgkin
  • Monoclonal gammapathies of undetermined significance
 
Clinical Cases 19 0