Yilmaz Suzan Guven, Ture Gamze, Zengin Mehmet Özgür, Talay Ekrem, Men Suleyman
Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir - Turkey.
Eur J Ophthalmol. 2015 Jan-Feb;25(1):77-9. doi: 10.5301/ejo.5000489. Epub 2014 May 12.
To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma.
Case report.
A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve.
Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving.
报告一例以视神经和硬脑膜受累为首发表现的多发性骨髓瘤病例。
病例报告。
一名43岁女性出现头痛和双眼视力下降。眼科检查发现前葡萄膜炎以及双侧视神经周围视网膜下肿块并伴有视盘水肿。磁共振成像显示硬脑膜和视神经浸润，视神经鞘呈轨道状强化。经全身检查确诊为多发性骨髓瘤。患者接受了全身化疗和颅脑放疗。治疗后，患者头痛消失，视乳头水肿消退，眼部症状有所改善，但由于视网膜下纤维组织和视神经退行性变，未能完全恢复。
多发性骨髓瘤的神经和眼科受累可能是疾病的首发表现。正确诊断很重要，因为这可能挽救生命。
