Watson Julia A, Olson Daniel J, Zhang Alice Yang
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Vitreoretin Dis. 2021 Feb 11;5(6):520-524. doi: 10.1177/2474126420987142. eCollection 2021 Nov-Dec.
This case report describes a case of hyperviscosity retinopathy secondary to the rare systemic hematologic malignant neoplasm Waldenström macroglobulinemia.
Fundus photography, fluorescein angiography, optical coherence tomography (OCT), and OCT angiography were used as imaging modalities to characterize this pathology.
A 51-year-old man presented with hyperviscosity retinopathy and uniquely angiographically silent serous macular detachment. Over a 6-month period, he was treated with systemic and local therapies with little improvement in the hyperviscosity retinopathy, serous macular detachments, or visual acuity.
Hyperviscosity retinopathy secondary to Waldenström macroglobulinemia presents a challenge to treating ophthalmologists given its rarity and the range of treatment responses described in the literature. Our patient's lack of response to antivascular endothelial growth factor and normal findings in OCT angiography and fluorescein angiography suggested the mechanism of subretinal fluid accumulation was not vascular endothelial growth factor mediated. Visual prognosis was guarded.
本病例报告描述了一例继发于罕见的系统性血液学恶性肿瘤——华氏巨球蛋白血症的高黏滞性视网膜病变。
使用眼底摄影、荧光素血管造影、光学相干断层扫描（OCT）和OCT血管造影作为成像方式来描述这种病理情况。
一名51岁男性患者出现高黏滞性视网膜病变以及独特的血管造影无异常表现的浆液性黄斑脱离。在6个月的时间里，他接受了全身和局部治疗，但高黏滞性视网膜病变、浆液性黄斑脱离或视力几乎没有改善。
继发于华氏巨球蛋白血症的高黏滞性视网膜病变因其罕见性以及文献中描述的一系列治疗反应，给眼科治疗医生带来了挑战。我们的患者对抗血管内皮生长因子治疗无反应，且OCT血管造影和荧光素血管造影结果正常，提示视网膜下液积聚的机制并非血管内皮生长因子介导。视力预后不容乐观。
