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Impressum
Bilateral retinal vein occlusion in a patient with immunocytoma and hyperviscosity syndrome
Widder R. A., Farvili E., Brunner R., Walter P.
Department of Ophthalmology - University of Cologne, Germany
Objective: Rheological disorders related to an increased hematocrit
are discussed as a cause for retinal vein occlusion. The following case
report describes a patient with a hyperviscosity syndrome and a low hematocrit
and in whom this constellation led to bilateral retinal vein occlusion.
Methods: Case-report.
Results: A 43 year old patient was seen with a sudden reduction
of visual acuity. Funduscopy revealed bilateral retinal vein occlusion.
The blood pressure was within a normal range. Blood samples were taken:
hematocrit 20 %, total-protein 14.4 g/dl (normal range <8.3 g/dl),
IgM 72 g/l (normal range <3.2 g/l). Plasma viscosity was increased
and a plasma exchange was performed. The following bone marrow examination
led to the diagnosis of an immunocytom and the patient was treated with
cytostatic drugs. After the treatment symptoms improved but the patient
developed a macular edema.
Conclusion: This case report demonstrates the need for a general
examination of patients with retinal vein occlusion. This patient could
be treated in a proper way before he developed other complications. Furthermore
the findings in this patient stress the role of an increased plasma viscosity
in this patient with retinal vein occlusion.