Ophthalmic Manifestations of Multiple Myeloma

Abstract

Purpose: To describe ophthalmic manifestations in a series of patients with multiple myeloma (MM) and review the literature. Design: Retrospective case series. Methods: Review of all cases with ophthalmic manifestations of MM seen at the Department of Ophthalmology, Royal Adelaide Hospital, between 1987 and 2002. Results: Of all patients with MM who were managed at the Royal Adelaide Hospital in the study period, only 8 were referred to the Ophthalmology Department with ophthalmic manifestations. Five males and 3 females with a mean age of 61.25 years (range 42–78) who exhibited ophthalmic manifestations were studied. Six patients (75%) had known MM at the time of their ophthalmic evaluation. Four patients (50%) had neuro-ophthalmic symptoms resulting in diplopia or visual disturbances. Three patients (37.5%) presented with orbital involvement and 1 (12.5%) with hyperviscosity retinopathy. Five patients (62.5%) died within 2 months of their ophthalmic presentation. Conclusion: Ophthalmic manifestations of MM are uncommon and diverse. They may appear at the initial presentation of the disease or occur late in the disease process. Awareness of the possible manifestations may lead to an earlier diagnosis and have a positive influence on the disease course.

Good Anatomical Outcome of Orbital Plasmacytoma Following Chemo-Radiotherapy

“…It affects many organ systems and typically presents with bone lesions, anaemia, hypercalcemia, kidney disease, bone marrow failure and various infections (Turaka 2014;Fung et al 2005). Neoplastic plasma cell tumours arising in soft tissues without primary osseus involvement is normally known as primary extramedullary plasmacytoma (Aboud et al 1995).…”

Corneal Structural Changes in Nonneoplastic and Neoplastic Monoclonal Gammopathies

“…4,5 Among the ocular complications, corneal involvement is less well recognized than others. 7 Precise epidemiologic studies on the prevalence of corneal involvement in monoclonal gammopathies are not available; data from Bourne et al 37 showed a prevalence of one case out of 100 gammopathic patients, while in a prospective study, Aronson and Shaw 38 detected no corneal deposits in 13 patients with MM.…”

“…Finally, MM is a malignant plasma cell disorder characterized by excess BM plasma cells, monoclonal protein, osteolytic bone lesions, renal disease, anemia, and hypercalcemia. 1,2 The eye can be involved in monoclonal gammopathies as a consequence of the ophthalmic localization, 3 blood hyperviscosity, 4,5 or deposition of light chains in the ocular tissues. 6 Among the ocular localizations, corneal involvement is the less well recognized than others.…”

Isolated orbital relapse of multiple myeloma in a patient with severe chronic GVHD after allogeneic hematopoietic SCT

“…1,2 Whilst ocular involvement in chronic GVHD (cGVHD) is a frequent complication after alloHSCT, 3 ocular involvement by multiple myeloma is rare. 4 Here, we report a case of a 42-year-old male patient who presented with isolated orbital relapse of multiple myeloma during treatment of severe ocular cGVHD. He received alloHSCT from a gender-and HLA-matched sibling PBSC donor after conditioning with treosulfan and fludarabin as primary treatment for multiple myeloma (IgA-kappa) in partial remission after autologous HSCT in August 2007.…”

“…They can be the result of direct tissue infiltration by plasma cells or from increased blood viscosity. 4 Orbital involvement as an indicator of extramedullary recurrence of multiple myeloma in patients thought to be in remission is an exceptional case. 5 Common symptoms of orbital involvement by multiple myeloma are proptosis, decreased vision, diplopia, swelling and ptosis.…”