Unusual immunogammopathy maculopathy

Purpose: To describe an unusual maculopathy in patients with serum immunoga mmopathies. Design: Retrospective observational small case series. Participants: Three patients derived from the clinical retina practices of the authors were noted to have unusual maculopathy. Methods: Each patient underwent fluorescein angiography and serum laborator y evaluation. Main Outcome Measure: Findings on fluorescein angiography, Results: An unusual and atypical macular detachment with or without subreti nal precipitates or fundus signs of serum hyperviscosity, such as retinal h emorrhages and dilated retinal veins, may be observed in patients with immu nogammopathies such as multiple myeloma, Waldenstrom's macroglobulinemia, a nd benign polyclonal gammopathy. Fluorescein angiography shows macular hypo fluorescence with no evidence of retinal vascular or retinal pigment epithe lial leakage within the macular elevation. Conclusions: Patients with atypical unilateral or bilateral macular detachm ent may be afflicted with a serum immunogammopathy such as multiple myeloma or Waldenstrom's macroglobulinemia, Diagnostic serum protein electrophores is and hematology consultation should be considered. Ophthalmology 2000;107 :1099-1103 (C) 2000 by the American Academy of Ophthalmology.