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. 2023 Aug 11;12(16):5227.
doi: 10.3390/jcm12165227.

Evaluation of Retinal Blood Flow in Patients with Monoclonal Gammopathy Using OCT Angiography

Cecilia Czakó  1 , Dóra Gerencsér  1 , Kitti Kormányos  1 , Klaudia Kéki-Kovács  1 , Orsolya Németh  2 , Gábor Tóth  1 , Gábor László Sándor  1 , Anita Csorba  1 , Achim Langenbucher  3 , Zoltán Zsolt Nagy  1 , Gergely Varga  4 , László Gopcsa  5 , Gábor Mikala  5 , Illés Kovács  1   6 , Nóra Szentmáry  1   7
Affiliations

Evaluation of Retinal Blood Flow in Patients with Monoclonal Gammopathy Using OCT Angiography

Cecilia Czakó et al. J Clin Med. .

Abstract

Background: Monoclonal gammopathy (MG) is characterized by monoclonal protein overproduction, potentially leading to the development of hyperviscosity syndrome.

Objective: To assess retinal circulation using optical coherence tomography angiography (OCTA) parameters in patients with monoclonal gammopathy.

Methods: OCTA measurements were performed using the Optovue AngioVue system by examining 44 eyes of 27 patients with MG and 62 eyes of 36 control subjects. Superficial and deep retinal capillary vessel density (VD SVP and DVP) in the whole 3 × 3 mm macular and parafoveal area, foveal avascular zone (FAZ) area, and central retinal thickness (CRT) were measured using the AngioAnalytics software. The OCTA parameters were evaluated in both groups using a multivariate regression model, after controlling for the effect of imaging quality (SQ).

Results: There was no significant difference in age between the subjects with monoclonal gammopathy and the controls (63.59 ± 9.33 vs. 58.01 ± 11.46 years; p > 0.05). Taking into account the effect of image quality, the VD SVP was significantly lower in the MG group compared to the control group (44.54 ± 3.22% vs. 46.62 ± 2.84%; p < 0.05). No significant differences were found between the two groups regarding the other OCTA parameters (p > 0.05).

Conclusions: A decreased superficial retinal capillary vessel density measured using OCTA in patients with MG suggests a slow blood flow, reduced capillary circulation, and consequent tissue hypoperfusion. An evaluation of retinal circulation using OCTA in cases of monoclonal gammopathy may be a sensitive method for the non-invasive detection and follow-up of early microcirculatory dysfunction caused by increased viscosity.

Keywords: hyperviscosity syndrome; monoclonal gammopathy; multiple myeloma; optical coherence tomography angiography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
En-face OCT angiogram and retinal vessel density map of the superficial retinal vascular plexus measured in the 3 × 3 mm macular using by OptoVue AngioVue OCT angiography in a patient with monoclonal gammopathy (A), and a healthy subject (B). OCT: optical coherence tomography.
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