Bilateral 'vitelliform-like' macular lesions in a patient with multiple myeloma.
A 73-year-old woman was referred to the eye clinic in February 2005 with reduced vision in both eyes. On examination, her visual acuity was 20/40, N6 right eye and 20/64, N6 left eye. Bilateral unusual 'vitelliform-like' lesions at the macula (accumulation of yellow material in the subretinal space), which demonstrated blocked fluorescence on fluorescein angiography and a lack of increased autofluorescence signal on fundus autofluorescence imaging, were detected. The patient was followed-up until April 2007 when retinal haemorrhages were detected and blood work-up was undertaken; during this follow-up period the material present at the macula progressively disappeared. As a result of the blood work-up, the diagnosis of multiple myeloma was established; the macular lesions were thought to relate to the latter disease and represent subretinal deposition of immunoglobulin.
Department of Ophthalmology, Grampian University Hospitals-NHS Trust, Foresterhill, Aberdeen, UK.
Javeed M
JM
Khan
Vikki
V
McBain
Cynthia
C
Santiago
Noemi
N
Lois
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D014786:Vision Disorders / Q000209:etiology