The purpose is to report a case of immunogammopathy maculopathy and hyperviscosity retinopathy as the presenting feature of new-onset multiple myeloma (MM) in an otherwise healthy man. A 50-years-old man presented with painless visual changes in both eyes for 2 months. Ocular examination revealed bilateral CRVO-like associated with macular edema (ME) and an inferior serous detachment. Hematologic investigation revealed an increased percentage of plasma cells in the bone marrow, reaching the diagnosis of MM IgM/kappa. Clinical support and chemotherapy effectively improved ocular alterations, despite the residual ME. Injection of triamcinolone was carried out, without any response. Bilateral vision reduction with hyperviscosity syndrome-related retinopathy and immunogammopathy maculopathy was the first manifestation of an underlying systemic and potentially fatal disease. This case highlights the need for diligent and thorough investigations for less common systemic conditions associated with retinal vein occlusions.
Case Rep Ophthalmol 2021;12:578–584

中文翻译：

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作为多发性骨髓瘤的新发病的高粘滞性视网膜病和免疫球蛋白病

目的是报告一例免疫球蛋白黄斑病变和高粘滞性视网膜病变，作为其他健康男性新发多发性骨髓瘤 (MM) 的表现特征。一名 50 岁男性出现双眼无痛性视力变化 2 个月。眼科检查显示双侧 CRVO 样与黄斑水肿 (ME) 和下浆液脱离相关。血液学检查显示骨髓中浆细胞的百分比增加，达到 MM IgM/kappa 的诊断。尽管残留 ME，但临床支持和化疗有效地改善了眼部改变。注射了曲安西龙，没有任何反应。双侧视力下降伴有高粘滞血症相关的视网膜病变和免疫球蛋白病黄斑病变是潜在全身性和潜在致命疾病的第一个表现。这个案例强调了对与视网膜静脉阻塞相关的不太常见的全身性疾病进行认真和彻底调查的必要性。
Case Rep Ophthalmol 2021；12:578–584