title: Unusual immunogammopathy maculopathy.
abstract: OBJECTIVE
  To describe an unusual maculopathy in patients with serum immunogammopathies.
  
  
  METHODS
  Retrospective observational small case series.
  
  
  METHODS
  Three patients derived from the clinical retina practices of the authors were noted to have unusual maculopathy.
  
  
  METHODS
  Each patient underwent fluorescein angiography and serum laboratory evaluation.
  
  
  METHODS
  Findings on fluorescein angiography.
  
  
  RESULTS
  An unusual and atypical macular detachment with or without subretinal precipitates or fundus signs of serum hyperviscosity, such as retinal hemorrhages and dilated retinal veins, may be observed in patients with immunogammopathies such as multiple myeloma, Waldenström's macroglobulinemia, and benign polyclonal gammopathy. Fluorescein angiography shows macular hypofluorescence with no evidence of retinal vascular or retinal pigment epithelial leakage within the macular elevation.
  
  
  CONCLUSIONS
  Patients with atypical unilateral or bilateral macular detachment may be afflicted with a serum immunogammopathy such as multiple myeloma or Waldenström's macroglobulinemia. Diagnostic serum protein electrophoresis and hematology consultation should be considered.
authors.affiliation: Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Ho
authors.forename: W E
authors.initials: WE
authors.lastname: Benson
authors.forename: J
authors.initials: J
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001809:Blood Viscosity; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications* / Q000175:diagnosis; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010266:Paraproteins / Q000032:analysis; D012163:Retinal Detachment / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D014792:Visual Acuity; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010266:Paraproteins