表现为难治性黄斑水肿的多发性骨髓瘤
Multiple Myeloma Presenting as Recalcitrant Macular Edema.
作者信息
Wisely C Ellis, Zhang Wenlan, Grewal Dilraj S
机构信息
Department of Ophthalmology, Duke University Health System, Durham, NC, USA.
出版信息
J Vitreoretin Dis. 2019 Oct 21;4(3):248-252. doi: 10.1177/2474126419880491. eCollection 2020 Jun.
PURPOSE
This article presents an unusual case of ocular involvement of multiple myeloma masquerading as macular edema associated with diabetic retinopathy.
METHODS
A report of a single case.
RESULTS
The presence of concomitant type 2 diabetes and scattered retinal hemorrhages presented a diagnostic challenge. Large globular vitreous opacities and significant weight loss were suggestive of a neoplastic process. We demonstrate multimodal imaging findings that can be associated with plasma cell dyscrasias and also describe the purported mechanism by which plasma cell dyscrasias cause macular edema and exudative retinal detachments.
CONCLUSION
Although multiple myeloma and related plasma cell dyscrasias are rare causes of ocular disease, they should be considered in the differential diagnosis of recalcitrant macular edema, and there should be a low threshold for systemic evaluation.
目的
本文介绍了一例罕见的多发性骨髓瘤眼部受累病例，其表现为伪装成与糖尿病视网膜病变相关的黄斑水肿。
方法
单病例报告。
结果
2型糖尿病合并散在性视网膜出血的存在带来了诊断挑战。大量球状玻璃体混浊和显著体重减轻提示存在肿瘤性病变。我们展示了与浆细胞异常增生相关的多模态成像结果，并描述了浆细胞异常增生导致黄斑水肿和渗出性视网膜脱离的推测机制。
结论
尽管多发性骨髓瘤及相关浆细胞异常增生是眼部疾病的罕见病因，但在顽固性黄斑水肿的鉴别诊断中应予以考虑，且进行全身评估的阈值应较低。
Zotero 插件