Multiple myeloma is the most common plasma cell tumor; however, ocular plasmacytomas are rare. Few cases of binocular metastasis have been reported. The authors review a case study using intraocular bevacizumab to treat secondary glaucoma and binocular metastasis from multiple myeloma.
A 59-year-old woman with a 13-month history of multiple myeloma was found to have a suspected masquerade syndrome OS and subsequently developed a neovascular glaucoma within 2 months. Intravitreal bevacizumab injection OS controlled the intraocular pressure and inhibited ocular metastasis. The methods of therapy administration in this case are consistent with procedures commonly used in clinical practice when using bevacizumab to treat other etiologies, such as choroidal neovascular membranes. Lost to follow-up until 2 months later, the patient presented with ocular metastasis OD with the same changes as observed OS. Conjunctival biopsy revealed subconjunctival plasmoma OD. After intravitreal bevacizumab injection, neovascular glaucoma OD was partly controlled.
Secondary ocular plasmacytoma, despite its rarity, should be considered in patients with multiple myeloma. Intravitreal bevacizumab injection may be a promising treatment for ocular metastases and associated secondary or neovascular glaucoma.