Dr.Shifa Yousuf

Dr.Manmath Kumar Das, Dr.Lalitha C.S., Dr.Das Matuli

Abstract

Study design– Case report
Purpose – To report a case of primary ocular manifestation of multiple myeloma and describe clinical features before and after treatment.
Method-A 62-year-old diabetic female diagnosed elsewhere as NPDR with DME for which she was treated with Intravitreal Avastin and triamcinolone injection following there was no improvement.Vision was 6/24,N18 and 4/60,N36. On funduscopy, huge neurosensory retinal detachment was seen on macula without any corresponding leaking microaneurysms on FFA.OCT revealed outer retinal schisis without hard exudates and CME.So, paraproteinemias was suspected and was investigated further. Serum electrophoresis,bence jones protein in urine analysis, whole body PET scan and bone marrow aspiration confirmed multiple myeloma.
Results- neurosensory retinal detachment completely resolved following chemotherapy.
Conclusion-paraproteinemias should be suspected in those patients where macular oedema does NOT have corresponding features on FFA.