Merz Tommaso, Marchesoni Ivan, Caminiti Giulia, Romanelli Federica
Multizone Unit of Ophthalmology of Autonomous Province of Trento, Trento, Italy.
Eur J Ophthalmol. 2022 Jul;32(4):NP48-NP51. doi: 10.1177/1120672121997069. Epub 2021 Feb 18.
To report a case of good clinical response to plasmapheresis as therapy for a bilateral hyperviscosity syndrome related retinopathy in a young patient with undiagnosed multiple myeloma (MM).
Case report.
A 48-year-old caucasian man, previously diagnosed with monoclonal gammopathy of undetermined significance (MGUS), presented for medical attention for back ache and vision decrease, worst in the left eye. Ophthalmological examination revealed presence of bilateral CRVO-like retinopathy which raised the hypothesis of hyperviscosity syndrome (HVS). After confirmation of MM diagnosis, plasmapheresis were promptly begun. The right eye regained a good visual acuity and an anatomical restoration already notable 5 days from the first plasmapheresis.
Fundoscopy lead to diagnosis of HVS, it is therefore advisable in all patients with MM in order to perform plasmapheresis as soon as possible if necessary. In case of atypical CRVO, haematological and inflammatory causes, should be always ruled out.
报告一例年轻的未确诊多发性骨髓瘤（MM）患者，其双侧高黏滞综合征相关性视网膜病变经血浆置换治疗后临床反应良好的病例。
病例报告。
一名48岁的白种男性，既往诊断为意义未明的单克隆丙种球蛋白病（MGUS），因背痛和视力下降前来就医，左眼症状最严重。眼科检查发现双侧类似视网膜中央静脉阻塞（CRVO）的视网膜病变，这引发了高黏滞综合征（HVS）的假设。确诊MM后，立即开始进行血浆置换。第一次血浆置换5天后，右眼视力恢复良好，且已出现明显的解剖学恢复。
眼底镜检查有助于诊断HVS，因此对于所有MM患者，如有必要，建议尽快进行血浆置换。对于非典型CRVO病例，应始终排除血液学和炎症性病因。
