Waldenström's macroglobulinaemia with intraocular hemorrhageThe aim of this work is to report a case of Waldenström's Macroglobulinaemia involving both retinal and choroidal circulation that resolved after treatment. The design is an interventional case report. A 47-year old male was admitted for evaluation of anaemia, and groin lymphadenopathy. A diagnosis of Waldenström's macroglobulinaemia was made based on clinical and laboratory findings. The patient developed intraocular hemorrhage without associated hypertension and with normal coagulation profile. A funduscopic examination revealed marked dilation and beading of the venous system, microaneurysms, and telangiectatic capillary beds in the posterior pole. A fluorescein angiography showed delayed choroidal filling, prolonged arteriovenous transit time and areas of capillary non-perfusion. These findings were accompanied by a severe IgM increase in serum viscosity. The most important ocular findings were reversible after plasmapheresis. Waldenström's macroglobulinaemia can involve both retinal and choroidal circulation. The prominent microvasculopathy is reversible after appropriate treatment.
Waldenström's macroglobulinaemia; immunoglobulins; multiple myeloma
