Unusual maculopathy secondary to hypergammaglobulinemia in a patient with systemic lupus erythematosus.
OBJECTIVE
To report the unusual findings of fluorescein angiography and optical coherence tomography in a case of systemic lupus erythematosus with hypergammaglobulinemia.


METHODS
Interventional case report.


RESULTS
A 59-year-old woman had systemic lupus erythematosus but had stopped taking medication for 6 months. Blurred vision was noted, and the fundoscopic findings revealed serous macular detachment. Results of optical coherence tomography demonstrated intraretinal and subretinal fluid, but fluorescein angiography showed no leakage. Her best-corrected visual acuity improved after posterior sub-Tenon triamcinolone injection.


CONCLUSIONS
Patients with atypical macular detachment may be afflicted with a serum immunogammopathy such as multiple myeloma, Waldenström's macroglobulinemia, and benign polyclonal gammopathy. Systemic lupus erythematosus should also be ruled out.
From the *Department of Ophthalmology, Changhua Christian Hospital, Changhua County, Taiwan; †Department of Optometry, Chung Hwa University of Medical Technology, Tainan County, Taiwan; ‡School of Medicine, Chung Shan Medical University, Taichung City, Taiwan; §Department of Allergy, Immunology, and Rheumatology, Changhua Christian Hospital, Changhua County, Taiwan; and ¶Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Chun-Ju
CJ
Lin
Ying-Ming
YM
Chiu
San-Ni
SN
Chen
Jiunn-Feng
JF
Hwang
Pei-Shin
PS
Hu