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Significance of ocular signs of monoclonal gammopathy
Author(s) -
Szentmary Nora
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.8056
Subject(s) - medicine , monoclonal gammopathy of undetermined significance , multiple myeloma , hematology , gammopathy , pathology , ophthalmology , monoclonal , monoclonal antibody , immunology , antibody
Monoclonal gammopathy of undetermined significance (MGUS), solitary bone plasmocytoma, Waldenström’s disease (macroglobulinaema) and asymptomatic or symptomatic multiple myeloma are all different stages of the same disease, all with monoclonal gammopathy. Up‐to date there are no data on ocular signs of monoclonal gammopathy , especially concerning corneal signs, in the literature. Our aim was to examine the ophthalmic signs of monoclonal gammopathy. Patients of the South‐Pest Hospital Center – National Institute for Infectology and Haematology , Department of Hematology and Stem Cell Transplantation, with monoclonal gammopathy, were enrolled in our study. Beside detailed ophthalmic and slit‐lamp examination, haematological history and blood counts were recorded and analysed. Fifty‐five patients were examined (17 male, 38 female, age 68±9.6 years). We observed corneal immunoglobulin deposition in 4 (7.28%), dry eye disease in 18 (32.75%), cataract in 28 (50.9%), epiretinal membrane in 4 (7.27%), glaucoma in 3 (5.45%), and a stage following central retinal artery occlusion in 1 patient (1.81%). 10 patients (20%) underwent cataract surgery prior enrollment, 7 of them (12,72%) had surgery on both eyes. Monoclonal gammopathy was related to IgG heavy chains in 41 (74.5%), IgA in 13 (23.5%) and IgM in 1 patient (1.81%) and concerning light chains, kappa‐chain was dominant in 35 (63.6%) and lambda in 20 patients (36.3%). Due to the relative high prevalence of dry eye disease and cataract in patients with monoclonal gammopathy, we recommend regular ophthalmological checkup of these patients. The occurrence of corneal deposits is relative uncommon (7,28%) in monoclonal gammopathy.