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TitleBilateral Ocular Plasmacytoma Presenting as Anterior Uveitis
Accept poster if oral is not possible ?Yes
PurposeTo report a case of bilateral plasmacytoma presenting as an acute anterior uveitis.
MethodsA case report.
ResultsA 64-year-old woman, presented to the ophthalmology outpatient clinic with abrupt onset of severe pain, blurred vision and redness in her right eye. Her medical history is remarkable for multiple myeloma, following bone marrow transplant and recurrent plasma cell leukemia, treated with biologic agent (Kyprolis). Examination revealed severe fibrinous anterior uveitis, accompanied by keratic precipitates, rubeosis iridis, hyphema, and raised intraocular pressure (IOP). The patient was treated intensively with topical steroids, IOP lowering agents, systemic acyclovir and prednisone, along with intracameral tissue plasminogen activator (TPA) injection followed by intra-vitreal bevacizumab injection, with partial improvement. Posterior synechiae, iris bombe and angle closure of 360º developed. An anterior segment ultrasound demonstrated severely thickened iris. Subconjunctival (SC) salmon patch was observed bilaterally. The patient had undergone SC biopsy that showed plasma cells infiltration, suggestive of plasmacytoma. Ruthenium plaque radiotherapy (dose of 40Gy) was initiated and a new cycle of systemic chemotherapy.
ConclusionExtramedullary plasmacytoma rarely involves ocular structures. In the setting of systemic malignancy, ocular involvement should always be considered, especially when acute inflammation is recalcitrant to therapy.
Conflict of interestNo
Author 1
Last nameSHARON
Initials of first name(s)Y
DepartmentDepartment of Ophthalmology, Rabin Medical Center
CityPetah-Tikva
CountryIsrael
Author 2
Last nameReich
Initials of first name(s)E
DepartmentDepartment of Ophthalmology, Rabin Medical Center
CityPetah-Tikva
CountryIsrael
Author 3
Last nameHayman
Initials of first name(s)L
DepartmentDepartment of Pathology, Rabin Medical Center
CityPetah-Tikva
CountryIsrael
Author 4
Last nameKramer
Initials of first name(s)M
DepartmentDepartment of Ophthalmology, Rabin Medical Center
CityPetah-Tikva
CountryIsrael