Case report: Bilateral simultaneous central retinal vein occlusion in Waldenstrom's macroglobulinemia

BACKGROUND: We report a case of bilateral simultaneous central retinal vein occlusion (CRVO) in Waldenstrom's macroglobulinemia. METHODS: We report the case of a 60-year-old woman who presented with decreased vision in both eyes. RESULTS: Ophthalmoscopic examination showed scattered retinal hemorrhages and venous tortuosity with macular edema bilaterally. The patient had a history of hypertension and was under investigation for lethargy, recurrent epistaxis, and fainting episodes. Serum protein electrophoresis showed an M-spike in the gamma region. Bone marrow trephine biopsy confirmed the diagnosis of Waldenstrom's macroglobulinemia. The patient was treated with plasmapheresis and subsequent chemotherapy, resulting in improvement of ocular and systemic symptoms. CONCLUSIONS: We report this case to emphasize that in any case of bilateral CRVO, hyperviscosity should be suspected. Serum electrophoresis along with coagulation profiles should be performed as a standard practice in patients with bilateral simultaneous CRVO. Optometry 2009;80:350-353