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Singh RB, Singhal S, Sinha S, Cho J, Nguyen AXL, Dhingra LS, Kaur S, Sharma V, Agarwal A. Ocular complications of plasma cell dyscrasias. Eur J Ophthalmol 2023; 33:1786-1800. [PMID: 36760117 PMCID: PMC10472748 DOI: 10.1177/11206721231155974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/21/2023] [Indexed: 02/11/2023]
Abstract
Plasma cell dyscrasias are a wide range of severe monoclonal gammopathies caused by pre-malignant or malignant plasma cells that over-secrete an abnormal monoclonal antibody. These disorders are associated with various systemic findings, including ophthalmological disorders. A search of PubMed, EMBASE, Scopus and Cochrane databases was performed in March 2021 to examine evidence pertaining to ocular complications in patients diagnosed with plasma cell dyscrasias. This review outlines the ocular complications associated with smoldering multiple myeloma and monoclonal gammopathy of undetermined significance, plasmacytomas, multiple myeloma, Waldenström's macroglobulinemia, systemic amyloidosis, Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes (POEMS) syndrome, and cryoglobulinemia. Although, the pathological mechanisms are not completely elucidated yet, wide-ranging ocular presentations have been identified over the years, evolving both the anterior and posterior segments of the eye. Moreover, the presenting symptoms also help in early diagnosis in asymptomatic patients. Therefore, it is imperative for the treating ophthalmologist and oncologist to maintain a high clinical suspicion for identifying the ophthalmological signs and diagnosing the underlying disease, preventing its progression through efficacious treatment strategies.
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Affiliation(s)
- Rohan Bir Singh
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Great Ormond Street Institute of Child Health, University College London, London, UK
- Discipline of Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Sachi Singhal
- Department of Internal Medicine, Crozer-Chester Medical Center, Upland, PA, USA
| | - Shruti Sinha
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Junsang Cho
- Department of Ophthalmology, Vanderbilt Eye Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Lovedeep Singh Dhingra
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Snimarjot Kaur
- Department of Pediatrics, Yale-New Haven Hospital, New Haven, CT, USA
| | - Vasudha Sharma
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Aniruddha Agarwal
- Department of Ophthalmology, University of Maastricht, Maastricht, the Netherlands
- Department of Ophthalmology, The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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Martel A, Gastaud L, Bonnetaud C, Nahon-Esteve S, Washetine K, Bordone O, Salah M, Tanga V, Fayada J, Lespinet V, Allegra M, Lalvee S, Zahaf K, Baillif S, Bertolotto C, Mograbi B, Lassalle S, Hofman P. Need for a Dedicated Ophthalmic Malignancy Clinico-Biological Biobank: The Nice Ocular MAlignancy (NOMA) Biobank. Cancers (Basel) 2023; 15:cancers15082372. [PMID: 37190299 DOI: 10.3390/cancers15082372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Ophthalmic malignancies include various rare neoplasms involving the conjunctiva, the uvea, or the periocular area. These tumors are characterized by their scarcity as well as their histological, and sometimes genetic, diversity. Uveal melanoma (UM) is the most common primary intraocular malignancy. UM raises three main challenges highlighting the specificity of ophthalmic malignancies. First, UM is a very rare malignancy with an estimated incidence of 6 cases per million inhabitants. Second, tissue biopsy is not routinely recommended due to the risk of extraocular dissemination. Third, UM is an aggressive cancer because it is estimated that about 50% of patients will experience metastatic spread without any curative treatment available at this stage. These challenges better explain the two main objectives in the creation of a dedicated UM biobank. First, collecting UM samples is essential due to tissue scarcity. Second, large-scale translational research programs based on stored human samples will help to better determine UM pathogenesis with the aim of identifying new biomarkers, allowing for early diagnosis and new targeted treatment modalities. Other periocular malignancies, such as conjunctival melanomas or orbital malignancies, also raise specific concerns. In this context, the number of biobanks worldwide dedicated to ocular malignancies is very limited. The aims of this article were (i) to describe the specific challenges raised by a dedicated ocular malignancy biobank, (ii) to report our experience in setting up such a biobank, and (iii) to discuss future perspectives in this field.
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Affiliation(s)
- Arnaud Martel
- Ophthalmology Department, Nice University Hospital, 06001 Nice, France
- Institute of Research on Cancer and Aging in Nice (IRCAN), Team 4, Centre Antoine Lacassagne, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06189 Nice, France
| | - Lauris Gastaud
- Oncology Department, Antoine Lacassagne Cancer Centre, 06000 Nice, France
| | - Christelle Bonnetaud
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | | | - Kevin Washetine
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06000 Nice, France
| | - Olivier Bordone
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06000 Nice, France
| | - Myriam Salah
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Virginie Tanga
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Julien Fayada
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Virginie Lespinet
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06000 Nice, France
| | - Maryline Allegra
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Salome Lalvee
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Katia Zahaf
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
| | - Stephanie Baillif
- Ophthalmology Department, Nice University Hospital, 06001 Nice, France
| | - Corine Bertolotto
- C3M, Institut National de la Santé et de la Recherche Médicale (INSERM), Côte d'Azur University, 06200 Nice, France
| | - Baharia Mograbi
- Institute of Research on Cancer and Aging in Nice (IRCAN), Team 4, Centre Antoine Lacassagne, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06189 Nice, France
| | - Sandra Lassalle
- Institute of Research on Cancer and Aging in Nice (IRCAN), Team 4, Centre Antoine Lacassagne, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06189 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06000 Nice, France
| | - Paul Hofman
- Institute of Research on Cancer and Aging in Nice (IRCAN), Team 4, Centre Antoine Lacassagne, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06189 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, CEDEX 1, 06001 Nice, France
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Fédération Hospitalo-Universitaire (FHU) OncoAge, Côte d'Azur University, 06000 Nice, France
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Augstburger E, Sahel JA, Audo I. Progressive chorioretinal involvement in a patient with light-chain (AL) amyloidosis: a case report. BMC Ophthalmol 2020; 20:59. [PMID: 32085748 PMCID: PMC7035659 DOI: 10.1186/s12886-020-01341-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background To report an unusual case of light-chain (AL) amyloidosis with progressive bilateral chorioretinal abnormalities documented with short-wavelength autofluorescence, SD-OCT, fluorescein and indocyanine green angiography. Case presentation Case report of a forty-three-year-old male patient with kappa AL amyloidosis. The patient presented with rapidly progressing pigmented and hyperautofluorescent drusenoid deposits in both eyes, associated with central serous retinal detachments, a pachychoroid and choriocapillaris enlargement. The general assessment revealed a renal failure symptomatic of a nephrotic syndrome, associated with proteinuria composed mainly of free kappa light chains. A kidney biopsy confirmed the diagnosis of kappa AL amyloidosis. Chemotherapy was quickly started. During remission, the extension of drusenoid deposits on the fundus was stopped and a disappearance of the subretinal fluid on SD-OCT was observed. Conclusions AL amyloidosis is an insidious and potentially fatal condition. This case is one of the first to document the rapid progression of fundus alterations and their stabilization after disease remission. Identifying these specific fundus abnormalities is essential to avoid diagnosis wandering and therapeutic delay.
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Affiliation(s)
- Edouard Augstburger
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Maladies Rares "dystrophies rétiniennes d'origine génétique", DHU Sight Restore INSERM-DHOS CIC 1423, 28, rue de Charenton, 75012, Paris, France.
| | - José-Alain Sahel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Maladies Rares "dystrophies rétiniennes d'origine génétique", DHU Sight Restore INSERM-DHOS CIC 1423, 28, rue de Charenton, 75012, Paris, France.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.,Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Isabelle Audo
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Centre de Maladies Rares "dystrophies rétiniennes d'origine génétique", DHU Sight Restore INSERM-DHOS CIC 1423, 28, rue de Charenton, 75012, Paris, France.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
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