Multimodal Imaging Characteristics and Risk Factors Analysis of Waldenström Macroglobulinemia Retinopathy

Abstract

To summarize the multimodal imaging features and analyze the risk factors of Waldenström macroglobulinemia retinopathy (WMR). Retrospective, cross-sectional study. Patients diagnosed with Waldenström macroglobulinemia and underwent ophthalmic examination in Peking Union Medical College Hospital in the last decade were included. Multimodal imaging characteristics of WMR were summarized. Univariate and multivariate logistic regression analysis of WMR and potential systemic and ocular factors was performed. A total of 50 WM patients were included in this study, and 28 patients had WMR in at least one eye. WMR was found to have worse LogMAR visual acuity (VA) (0.52±0.54 vs. 0.21±0.18, p=0.009), and was characterized by tortuous retinal vessels, extensive retinal hemorrhage, and distinctive shape of macular edema, etc. In univariate analysis, the presence of WMR was significantly associated with the mean VA (LogMAR), serum RBC counts, serum PLT counts, HGB level, serum M protein, serum IgM level, and LDH (with p<0.05). In multivariate analysis, WMR was significantly correlated with M protein (adjusted OR=1.127, 95% CI 1.052-1.209, p= 0.001) and serum IgM (adjusted OR=1.059, 95% CI 1.023-1.095, p= 0.001) with the predicted AUC of 0.820 and 0.859, respectively. The optimal cut-off values were 26.2g/L for M protein, and 51.0g/L for IgM, which accounts for a sensitivity of 95.4% and 95.4%, and specificity of 64.3% and 60.7%. Retinopathy of WM has specific characteristics in ophthalmic examinations. Serum IgM levels and M protein are good predictors of WMR, which could attach important value of fundus examinations for WM patients.