Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Department of Ophthalmology, Great Ormond Street Institute of Child Health, University College London, London, UK.
Eur J Ophthalmol. 2023 Sep;33(5):1786-1800. doi: 10.1177/11206721231155974. Epub 2023 Feb 9.
Plasma cell dyscrasias are a wide range of severe monoclonal gammopathies caused by pre-malignant or malignant plasma cells that over-secrete an abnormal monoclonal antibody. These disorders are associated with various systemic findings, including ophthalmological disorders. A search of PubMed, EMBASE, Scopus and Cochrane databases was performed in March 2021 to examine evidence pertaining to ocular complications in patients diagnosed with plasma cell dyscrasias. This review outlines the ocular complications associated with smoldering multiple myeloma and monoclonal gammopathy of undetermined significance, plasmacytomas, multiple myeloma, Waldenström's macroglobulinemia, systemic amyloidosis, Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes (POEMS) syndrome, and cryoglobulinemia. Although, the pathological mechanisms are not completely elucidated yet, wide-ranging ocular presentations have been identified over the years, evolving both the anterior and posterior segments of the eye. Moreover, the presenting symptoms also help in early diagnosis in asymptomatic patients. Therefore, it is imperative for the treating ophthalmologist and oncologist to maintain a high clinical suspicion for identifying the ophthalmological signs and diagnosing the underlying disease, preventing its progression through efficacious treatment strategies.
浆细胞疾病是一组由恶性或前恶性浆细胞过度分泌异常单克隆抗体引起的严重单克隆丙种球蛋白病。这些疾病与各种全身表现有关，包括眼部疾病。2021 年 3 月，我们在 PubMed、EMBASE、Scopus 和 Cochrane 数据库中进行了检索，以检查与浆细胞疾病患者眼部并发症相关的证据。本综述概述了与冒烟型多发性骨髓瘤和意义未明的单克隆丙种球蛋白血症、浆细胞瘤、多发性骨髓瘤、华氏巨球蛋白血症、系统性淀粉样变性、多发性神经病、器官肿大、内分泌病、单克隆丙种球蛋白血症和皮肤改变（POEMS）综合征和冷球蛋白血症相关的眼部并发症。虽然病理机制尚未完全阐明，但多年来已经确定了广泛的眼部表现，涉及眼睛的前节和后节。此外，出现的症状也有助于无症状患者的早期诊断。因此，治疗眼科医生和肿瘤学家必须保持高度的临床怀疑，以识别眼部体征并诊断潜在疾病，通过有效的治疗策略防止其进展。
