Abstract：
OBJECTIVE: Multiple myeloma (MM) is a plasma cell dyscrasia leading to proliferation of monoclonal plasma cells. Ocular involvement in multiple myeloma is uncommon but can occur. The ocular manifestations of MM may include the cornea, uvea, and retinal vasculature. We present a rare case of autoimmune retinopathy associated with smoldering MM.
METHODS: A 76-year-old female with no significant past medical or ocular history presented with four months of worsening vision, difficulty with night driving, and loss of peripheral vision. Examination was notable for pallor of the optic nerves and vascular attenuation. Visual field testing demonstrated significant and progressive field loss in both eyes. An electroretinogram was extinguished under all conditions. Serum protein electrophoresis showed a significant elevation of IgG with an M-spike, and a subsequent bone marrow biopsy was performed showing 12.5% plasma cells, consistent with the diagnosis of MM. CAR antibody testing was positive for anti-enolase, anti-GAPDH, and anti-Rab6 antibodies, consistent with autoimmune retinopathy.
CONCLUSIONS: Autoimmune retinopathy associated with MM is exceedingly rare. Management of this condition is challenging, as treatment of the underlying disease does not often lead to improvement in visual symptoms. Ultimately, visual prognosis is very poor, and both patients and clinicians should be aware of the guarded visual potential.
CONCLUSIONS: The association of autoimmune retinopathy with multiple myeloma is rare. It is crucial for physicians to be aware of such manifestations to ensure timely and appropriate diagnosis and management for patients.
METHODS: A 76-year-old female with no significant past medical or ocular history presented with four months of worsening vision, difficulty with night driving, and loss of peripheral vision. Examination was notable for pallor of the optic nerves and vascular attenuation. Visual field testing demonstrated significant and progressive field loss in both eyes. An electroretinogram was extinguished under all conditions. Serum protein electrophoresis showed a significant elevation of IgG with an M-spike, and a subsequent bone marrow biopsy was performed showing 12.5% plasma cells, consistent with the diagnosis of MM. CAR antibody testing was positive for anti-enolase, anti-GAPDH, and anti-Rab6 antibodies, consistent with autoimmune retinopathy.
CONCLUSIONS: Autoimmune retinopathy associated with MM is exceedingly rare. Management of this condition is challenging, as treatment of the underlying disease does not often lead to improvement in visual symptoms. Ultimately, visual prognosis is very poor, and both patients and clinicians should be aware of the guarded visual potential.
CONCLUSIONS: The association of autoimmune retinopathy with multiple myeloma is rare. It is crucial for physicians to be aware of such manifestations to ensure timely and appropriate diagnosis and management for patients.
摘要：
目的：多发性骨髓瘤（MM）是导致单克隆浆细胞增殖的浆细胞发育不良。多发性骨髓瘤的眼部受累并不常见，但可能发生。MM的眼部表现可能包括角膜，uvea,和视网膜血管.我们介绍了与闷烧MM相关的自身免疫性视网膜病的罕见病例。
方法：一名76岁女性，无明显既往病史或眼部病史，视力恶化4个月，夜间驾驶困难，和周围视力的丧失。检查可见视神经苍白和血管衰减。视野测试表明，两只眼睛都有明显的渐进性视野丧失。视网膜电图在所有条件下都消失。血清蛋白电泳显示IgG显着升高，具有M-spike，随后进行了骨髓活检，显示有12.5％的浆细胞，符合MM的诊断。CAR抗体检测抗烯醇化酶阳性，反GAPDH,和抗Rab6抗体，与自身免疫性视网膜病变一致。
结论：与MM相关的自身免疫性视网膜病变极为罕见。这种情况的管理具有挑战性，作为基础疾病的治疗通常不会导致视觉症状的改善。最终,视力预后很差，患者和临床医生都应该意识到受到保护的视觉潜力。
结论：自身免疫性视网膜病与多发性骨髓瘤的相关性很少见。对于医生来说，了解这些表现以确保对患者进行及时和适当的诊断和管理至关重要。
方法：一名76岁女性，无明显既往病史或眼部病史，视力恶化4个月，夜间驾驶困难，和周围视力的丧失。检查可见视神经苍白和血管衰减。视野测试表明，两只眼睛都有明显的渐进性视野丧失。视网膜电图在所有条件下都消失。血清蛋白电泳显示IgG显着升高，具有M-spike，随后进行了骨髓活检，显示有12.5％的浆细胞，符合MM的诊断。CAR抗体检测抗烯醇化酶阳性，反GAPDH,和抗Rab6抗体，与自身免疫性视网膜病变一致。
结论：与MM相关的自身免疫性视网膜病变极为罕见。这种情况的管理具有挑战性，作为基础疾病的治疗通常不会导致视觉症状的改善。最终,视力预后很差，患者和临床医生都应该意识到受到保护的视觉潜力。
结论：自身免疫性视网膜病与多发性骨髓瘤的相关性很少见。对于医生来说，了解这些表现以确保对患者进行及时和适当的诊断和管理至关重要。
