Serous detection of the neuroretina in Waldenström disease. A case report [in German]

Abstract

BACKGROUND: Waldenstrom's Macroglobulinemia is a monoclonal gammopathy producing pathologic IgM antibodies with increased blood viscosity, platelet dysfunction and retinal hemorrhages. As a complication a serous detachment of the macula is described. The pathogenesis of the serous detachment is still not fully understood. CASE REPORT: A 73-year-old male patient was presented with Waldenstrom's Macroglobulinemia, a typical hyperviscosity retinopathy and serous detachment of the macula. We performed fluorescein (FA)- and indocyaningreenangiography (ICG) before and three months after chemotherapy. Especially ICG-angiographic findings revealed a serous detachment that was restricted to the posterior pole but showed a fingershaped enlargement to the optic disc. CONCLUSION: FA- and especially ICG-angiographic findings can help to get more information about the pathogenetic mechanism of serous detachment in Waldenstrom's Macroglobulinemia. Besides toxic alteration of the retinal pigmentepithelium, oncotic and hydrostatic pressure, a pathologic communication between the optic disc, the subarachnoid space and the subretinal space is discussed