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A 73-year-old man presented with decreased vision in both eyes for 2 weeks. Best-corrected visual acuity was 20/100 OU. He was diagnosed with Waldenström macroglobulinemia (WM) by bone marrow biopsy because of chronic anemia. Genetic testing revealed an L265P somatic variant in the MYD88 gene, and serologic analysis showed an M protein level of 5670 mg/dL and a blood viscosity of 6.12 cP. On ultrawide-field fluorescein angiography (Figure), retinal hemorrhages obscured the fluorescence pattern. Retinal blood vessels were dilated, segmented, and beaded or tortuous with a “sausage link” appearance; vessel leakage was also observed.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Youxin Chen, MD, Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, China (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was supported by the nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences.
Role of the Funder/Sponsor: The funder had no role in the collection, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We thank the patient for granting permission to publish this information.
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