J Korean Ophthalmol Soc > Volume 57(6); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(6):1012-1017.
DOI: https://doi.org/10.3341/jkos.2016.57.6.1012    Published online June 15, 2016.
Bilateral Simultaneous Central Retinal Vein Occlusion in a Patient with Waldenstrom's Macroglobulinemia.
Sang Eon Lee, Yong Un Shin, Han Woong Lim, Min Chul Seong, Hee Yoon Cho, Min Ho Kang
Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. ocularimmunity@gmail.com
발덴스트룀 거대글로불린혈증 환자에게서 발생한 동시다발성 양안 중심망막정맥폐쇄 1예
이상언⋅신용운⋅임한웅⋅성민철⋅조희윤⋅강민호
한양대학교 의과대학 한양대학교구리병원 안과학교실
Correspondence:  Min Ho Kang,
Email: ocularimmunity@gmail.com
Received: 10 July 2015   • Revised: 19 September 2015   • Accepted: 14 November 2015
Abstract
PURPOSE
The authors report a case of bilateral simultaneous central retinal vein occlusion caused by Waldenstrom's macroglobulinemia. CASE SUMMARY: A 65-year-old man presented to our department complaining of decreased visual acuity for the duration of about 6 months. On his initial visit, best-corrected visual acuity was 0.02 in the right eye and 0.06 in the left eye. Based on the findings of a funduscopic examination, the patient had bilateral diffuse retinal hemorrhages, dilated tortuous veins, and macular edema. He had experienced recurrent spontaneous epistaxis 6 months previously and had undergone treatments such as intravitreal bevacizumab injection and intravitreal dexamethasone implantation at another hospital. Laboratory tests at that hospital showed anemia and hyperproteinemia, for which he was referred to our hemato-oncology department. Bone marrow biopsy was consistent with Waldenstrom's macroglobulinemia/lymphoplasmacytoid lymphoma, and he was treated with systemic chemotherapy. One year after the systemic chemotherapy, his best-corrected visual acuity was 0.15 in the right eye and 0.6 in the left eye. Funduscopy showed decreased bilateral retinal hemorrhages and macular edema. CONCLUSIONS: When simultaneous bilateral central retinal vein occlusion occurs in a patient with no other underlying disease such as hypertension or diabetes, it might be a sign of serum hyperviscosity, and there should be a very high level of suspicion for presence or progression of systemic disease. If such a disease is properly and timely diagnosed, effective early systemic evaluation and therapy can be administered, and it is important to have initial general treatment as well as ophthalmic treatment.
Key Words: Central retinal vein occlusion;Waldenstrom's macroglobulinemia


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