Optical coherence tomography angiography characteristics in Waldenström macroglobulinemia retinopathy: A case report

Figure 1 Fundus photographs revealing venous dilation, tortuosity, and macular edema in the right eye and macular edema, extensive hemorrhages, and cotton wool spots in the left eye. A: The right eye; B: The left eye.

Figure 2 Bone marrow examination results. A: Bone marrow aspiration smears. Plasmacytoid cells are labelled with arrows; B: Bone marrow biopsy showed diffused infiltration by small lymphoid and plasmacytoid cells by hematoxylin and eosin staining; C: Flow cytometry assay showed that the populations in P3 group (8.3%) were mature clonal B cells, mainly expressing CD19, CD20, CD22, CXCR4, and HLA-DR and partially expressing cKappa.

Figure 3 Spectral domain optical coherence tomography images. A: Serous macular detachment with intraretinal edema in the outer plexiform layer (OPL). Central retinal thickness (CRT) = 607 µm, and central choroidal thickness (CCT) = 148 µm (right eye); B: Intraretinal edema in the OPL. CRT = 1101 µm, and CCT = 123 µm (left eye); C: 1 mo after intravitreal ranibizumab (IVR). CRT = 530 µm, and CCT = 155 µm (right eye); D: 1 mo after IVR. CRT = 976 µm, and CCT = 113 µm (left eye); E: 6 mo after IVR. Complete resolution of intraretinal edema was achieved. CRT = 500 µm, and CCT = 131 µm (right eye); F: 6 mo after IVR. Nearly complete resolution of intraretinal edema was achieved. CRT = 559 µm, and CCT = 90 µm (left eye).

Figure 4 Transverse optical coherence tomography angiograms showing the disrupted retinal vasculature and intraretinal edema in both eyes and improvement after intravitreal ranibizumab. A: Baseline superficial capillary plexus (internal limiting membrane to inner plexiform layer) (right eye); B: Baseline deep capillary plexus (inner plexiform layer to outer plexiform layer) (right eye); C: 1 mo after intravitreal ranibizumab (IVR) (superficial; right eye); D: 1 mo after IVR (deep; right eye); E: 6 mo after IVR (superficial; right eye); F: 6 mo after IVR (deep; right eye); G: Baseline (the whole sensory retina; left eye); H: 1 mo after IVR (the whole sensory retina; left eye).

Figure 5 Transverse structural optical coherence tomography angiography images. A: Dilated choroidal large blood vessels on the right eye; B: Improvement 1 mo after intravitreal ranibizumab; C: Dilated choroidal large blood vessels on the left eye; D: Improvement 1 mo after intravitreal ranibizumab.