Objective: To examine ocular signs and ocular comorbidities in monoclonal gammopathy.
Patients and methods: We analyzed patients from two large referral hematology centers
in Budapest, who were diagnosed and/or treated with monoclonal gammopathy between
1997 and 2020 (84 eyes of 42 patients, 42.86% male, mean age 63.83 +/- 10.76 years).
Before the ophthalmic examination, the subjects filled in the Ocular Surface Disease
Index (OSDI) questionnaire. Ophthalmic examination included visual acuity test and
slit-lamp examination following dilation of the pupil. Results: OSDI scores were significantly
higher in subjects with monoclonal gammopathy than in controls (p = 0.002). Among
gammopathy subjects, we observed potential corneal immunoglobulin deposition in 5
eyes of 3 patients (5.95%). In gammopathy subjects, there was dry eye disease (66.67%),
cataract (55.95%), Meibomian gland dysfunction (20.24%), posterior cortical cataract
(19.05%), corneal scars and degenerations (17.86%), chronic blepharitis (14.29%),
absence of ocular complaint (11.90%), macular or retinal drusen (9.52%), corneal immunoglobulin
deposition (5.95%), epiretinal membrane (5.95%), previous cataract surgery (5.95%),
glaucoma (4.76%), Fuchs dystrophy (2.38%), peripheral retinal degeneration (2.38%),
chorioideal naevus (2.38%), diabetic retinopathy (1.19%), central retinal artery occlusion
(1.19%), central retinal vein branch occlusion (1.19%) and amblyopia (1.19%). The
proportion of dry eye disease (p = 0.002), posterior cortical cataract (p = 0.001),
cataract (p<0.00001), and corneal scars and degenerations (p = 0.01) were significantly
higher in gammopathy subjects than in controls. Conclusion: Dry eye disease and cataracts
are the most common ocular comorbidities in patients with monoclonal gammopathy. Therefore,
due to the potential ocular signs and comorbidities of monoclonal gammopathy, we suggest
a regular, yearly ophthalmic checkup of these patients to improve their quality of
life.
