Case report: bilateral simultaneous central retinal vein occlusion in Waldenström's macroglobulinemia.
BACKGROUND
We report a case of bilateral simultaneous central retinal vein occlusion (CRVO) in Waldenström's macroglobulinemia.


METHODS
We report the case of a 60-year-old woman who presented with decreased vision in both eyes.


RESULTS
Ophthalmoscopic examination showed scattered retinal hemorrhages and venous tortuosity with macular edema bilaterally. The patient had a history of hypertension and was under investigation for lethargy, recurrent epistaxis, and fainting episodes. Serum protein electrophoresis showed an M-spike in the gamma region. Bone marrow trephine biopsy confirmed the diagnosis of Waldenström's macroglobulinemia. The patient was treated with plasmapheresis and subsequent chemotherapy, resulting in improvement of ocular and systemic symptoms.


CONCLUSIONS
We report this case to emphasize that in any case of bilateral CRVO, hyperviscosity should be suspected. Serum electrophoresis along with coagulation profiles should be performed as a standard practice in patients with bilateral simultaneous CRVO.
Chanana
Bhuvan
B
All India Institute of Medical Sciences, New Delhi, India. bhuvan_chanana@rediffmail.com
Gupta
Nitin
N
Azad
Raj Vardhan
RV
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001798:Blood Proteins / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004586:Electrophoresis; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000209:etiology; D008875:Middle Aged; D010956:Plasmapheresis; D011241:Prednisone / Q000627:therapeutic use; D012170:Retinal Vein Occlusion / Q000209:etiology* / Q000503:physiopathology*; D014750:Vincristine / Q000627:therapeutic use; D015348:Vision, Binocular; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy
D001798:Blood Proteins; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone