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Roth spots as debut of multiple myeloma

Published:September 17, 2020DOI:https://doi.org/10.1016/j.jcjo.2020.08.007
      A previously healthy 42-year-old man complained of sudden visual loss in the left eye 1 day before the consultation. Funduscopic examination showed the right eye with dilatation and tortuosity of the veins, multiple Roth spots, flame-shaped and dot-blot intraretinal hemorrhages. Optic nerve and foveola showed no alterations (Fig. 1.1). The left eye showed similar characteristics but with more abundant and confluent hemorrhages. A preretinal hemorrhage was present on the macula, which explains the sudden loss of vision (Fig. 1.2). He was referred for a multidisciplinary evaluation, and diagnostic studies were conclusive for multiple myeloma.
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