The Spectrum of Ocular Manifestations in Patients with Waldenström's Macroglobulinemia.
Rosanna DammaccoWalter LischTero T KiveläEvangelos TerposEfstathios KastritisDario SistoAlberto MavilioRoberto RiaGiovanni AlessioAngelo VaccaFranco DammaccoPublished in: Ocular immunology and inflammation (2021)
Purpose: To investigate the ocular manifestations in 91 Waldenström's macroglobulinemia (WM) patients.Methods: Retrospective, cross-sectional, observational analysis.Results: Ocular impairments, detected in 19 patients, included flame-shaped hemorrhages, venous sausaging, papilledema, macular detachments, or central retinal vein occlusion in 16 patients; paraproteinemic keratopathy in 2; and a CANOMAD syndrome in 1. Best-corrected visual acuity was ≥0.5 logMAR units in 11 of 38 eyes. Intraocular pressure was increased in seven eyes. Genetic analysis in seven patients showed a mutation in the MYD88 gene in six patients and a nonsense mutation in the CXCR4 gene in five patients. Plasmapheresis followed by chemotherapy with or without the addition of rituximab resulted in improvement or normalization of the ophthalmological findings in 15 patients.Conclusion: The ocular manifestations of WM are protean and potentially sight threatening. Recent advances in genomic profiling and chemotherapy have remarkably improved the hematological and ophthalmological outcomes of these patients.
Keyphrases
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- patient reported outcomes
- optical coherence tomography
- immune response
- high resolution
- radiation therapy
- inflammatory response
- adipose tissue
- diffuse large b cell lymphoma
- insulin resistance
- data analysis
- simultaneous determination
- age related macular degeneration