IgG多発性骨髄腫に生じた両眼網膜中心静脈閉塞症の1例

The bilateral central retinal vein occlusions in a patient with IgG multiple myeloma

　多発性骨髄腫は血液の過粘稠性を伴うことが知られているが，これに基づくと考えられる網膜中心静脈閉塞症を合併したIgG・χ型多発性骨髄腫の1症例を経験したので報告した。

A 43-year-old Japanese man noted sudden blur-red vision of the left eye during therapy for IgG-χ type multiple myeloma. At the initial ocular exami-nation, the visual acuity was 1.0 (1.0) in the right eye and 0.6 (1.0) in the left. Fundus examination revealed numerous hemorrhages and diffuse edema from the posterior pole to equator in both eyes. We diagnosed central retinal vein occlusion of both eyes. The bulbar conjunctiva was normal. Physical examination showed anemia, a very high level of abnormal immunoglobulin, high serum hypervis-cosity, costal fractures and osteolytic lesions. Urinalysis showed no Bence Jones protein, but renal function was decreased. These findings sug-gest that central retinal vein occlusion of both eyes may be caused by accelerated thrombogenesis due to serum hyperviscosity, venous stasis, increased vascular leakage and occluded microvessels. Two months after the onset, the visual acuity of both eyes had decreased 0.1