Unusual maculopathy secondary to hypergammaglobulinemia in a patient with systemic lupus erythematosus.

PURPOSE: To report the unusual findings of fluorescein angiography and optical coherence tomography in a case of systemic lupus erythematosus with hypergammaglobulinemia.

DESIGN

Interventional case report.

RESULTS

A 59-year-old woman had systemic lupus erythematosus but had stopped taking medication for 6 months. Blurred vision was noted, and the fundoscopic findings revealed serous macular detachment. Results of optical coherence tomography demonstrated intraretinal and subretinal fluid, but fluorescein angiography showed no leakage. Her best-corrected visual acuity improved after posterior sub-Tenon triamcinolone injection.

CONCLUSION

Patients with atypical macular detachment may be afflicted with a serum immunogammopathy such as multiple myeloma, Waldenström's macroglobulinemia, and benign polyclonal gammopathy. Systemic lupus erythematosus should also be ruled out.