Author: Petra Hübnerová (Czech Republic)
Co-authors: Martin Šín, Jiří Minařík, Petra Krhovská, Marta Karhanová, Barbora Pašková, Zuzana Schreiberová
Purpose
The aim of our study was a pilot assessment of a retinal oxygen saturation in patients with monoclonal gammopathies, i.e. in patients with typical production of monoclonal immunoglobulin in serum such as multiple myeloma, monoclonal gammopathy of undetermined significance, Waldenström‘s macroglobulinemia and amyloid light-chain amyloidosis.
Setting/Venue
Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry of Palacky University Olomouc, Czech Republic, Europe Department of Haemato-oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry of Palacky University Olomouc, Czech Republic, Europe Faculty of Medicine and Dentistry of Palacky University Olomouc, Czech Republic, Europe
Methods
Twenty-nine patients with monoclonal gammopathies were enrolled during years 2016-2020 (10 females, 19 males, mean age 65 years). The patients were diagnosed at the Department of Haemato-oncology with subsequent examination at the Department of Ophthalmology before the start of the systemic treatment. All patients were examined using automatic retinal oximetry (Oxymap, ehf. Reykjavik, Iceland) together with ocular fundus photography (retinal camera Topcon TRC-50DX). We assessed the association of retinal oxygen saturation (SatO2) - arterial SatO2, venous SatO2, arteriovenous (A-V) difference - and the following parameters of monoclonal gammopathies: total protein, viscosity, the level of serum myeloma protein (M-protein) and serum light chains (kappa and lambda), haemoglobin, albumin, lactate dehydrogenase (LDH), C-reactive protein (CRP), creatinin (Cr) and serum calcium (Ca).
Results
The correlation analysis did not find a statistical significance between retinal oxygen saturation and total protein or with viscosity. Similarly, there was no correlation between retinal oxygen saturation and albumin, LDH, CRP, Cr or Ca. We found a significant positive correlation of A-V difference and the level of haemoglobin (p value=0,031). There was a trend towards negative correlation of serum levels of M-protein and A-V difference, but the association was not statistically significant. But, there was a significant moderately strong negative correlation of A-V difference and the concentration of serum monoclonal light chains lambda (p value=0,012).
Conlusions
Our pilot study revealed the correlation between the retinal oxygen saturation and some selected parameters in the blood of patients with monoclonal gammopathies. It seems that the levels of monoclonal immunoglobulin lead to decreased oxygen uptake in retina arteriols thus resulting in lower A-V difference of oxygen saturation, especially seen in patients with high levels of lambda light chains of immunoglobulin. The results were in part affected by simultaneous anaemia which also lead to lower A-V difference. With increasing levels of haemoglobin, the A-V difference became more apparent. We conclude that the assessment of retinal oxygation might be a useful tool in the diagnostics of patients with monoclonal gammopathies. Supported by MH CZ – DRO (FNOl, 00098892) Supported by Ministry of Health of the Czech Republic, grant nr. NU21J-01-00017. All rights reserved.
Financial Disclosure
Supported by MH CZ – DRO (FNOl, 00098892) Supported by Ministry of Health of the Czech Republic, grant nr. NU21J-01-00017. All rights reserved.
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