多发性骨髓瘤患者的双侧渗出性视网膜脱离和全葡萄膜炎。
Bilateral Exudative Retinal Detachments and Panuveitis in a Patient with Multiple Myeloma.
机构信息
National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
出版信息
Ocul Immunol Inflamm. 2024 Sep;32(7):1448-1453. doi: 10.1080/09273948.2023.2217914. Epub 2023 Jun 8.
PURPOSE
To report a case of bilateral exudative retinal detachments and panuveitis in a patient with multiple myeloma (MM).
CASE REPORT
A 54-year-old patient with non-proliferative diabetic retinopathy was referred with blurred vision and scotomas in both eyes (OU). Three months prior to the onset of ocular symptoms, he was diagnosed with systemic MM and was receiving chemotherapy. Clinical examination revealed best-corrected visual acuities of 20/80 OU, rare anterior chamber cell, 2+ vitreous cell, diffuse intraretinal hemorrhages, and exudative retinal detachments (RD). Optical coherence tomography of the macula showed central subretinal fluid with cystic intraretinal fluid OU. The findings were consistent with panuveitis and exudative RD in the setting of MM. He reported symptomatic improvement after plasmapheresis and oral prednisone initiation.
CONCLUSION
Extensive, bilateral exudative RD and panuveitis are rare but potentially sight-threatening findings in patients with MM.
目的
报告一例多发性骨髓瘤（MM）患者双侧渗出性视网膜脱离和全葡萄膜炎病例。
病例报告
一名 54 岁患者患有非增殖性糖尿病性视网膜病变，因双眼视力模糊和视野缺损（OU）而就诊。在出现眼部症状前 3 个月，他被诊断为全身性 MM，并接受化疗。临床检查显示最佳矫正视力 OU 为 20/80，前房细胞罕见，玻璃体细胞 2+，弥漫性视网膜内出血和渗出性视网膜脱离（RD）。黄斑区光学相干断层扫描显示中央性视网膜下积液伴 OU 囊性视网膜内液。这些发现与 MM 背景下的全葡萄膜炎和渗出性 RD 相符。他报告说，在进行血浆置换和口服泼尼松治疗后症状有所改善。
结论
广泛的双侧渗出性 RD 和全葡萄膜炎是 MM 患者罕见但潜在致盲的表现。
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