Journal de médecine légale

Assessment of Retinal Blood Flow in Individuals with Monoclonal Gammopathy Utilizing OCT Angiography

Abstract

Gábor Gerencsér

Monoclonal Gammopathy (MG) is characterized by the excessive production of monoclonal proteins, potentially leading to the onset of hyperviscosity syndrome. This study aims to evaluate retinal circulation utilizing optical coherence tomography angiography parameters in individuals with monoclonal gammopathy. The study involved OCTA measurements using the Optovue AngioVue system, analyzing 44 eyes of 27 MG patients and 62 eyes of 36 control subjects. Parameters such as superficial and deep retinal capillary vessel density (VD SVP and DVP) across the entire 3 × 3 mm macular and parafoveal region, foveal avascular zone (FAZ) area, and central retinal thickness (CRT) were quantified using AngioAnalytics software. Employing a multivariate regression model, the OCTA parameters were compared between the two groups, with adjustments for imaging quality (SQ). Age showed no significant difference between monoclonal gammopathy subjects and controls (63.59 ± 9.33 vs. 58.01 ± 11.46 years; p>0.05). After accounting for image quality, VD SVP was notably lower in the MG group than the control group (44.54 ± 3.22% vs. 46.62 ± 2.84%; p<0.05). No significant disparities were observed in the other OCTA parameters between the groups (p>0.05). The reduced superficial retinal capillary vessel density, as indicated by OCTA, in MG patients implies sluggish blood flow, diminished capillary circulation, and subsequent tissue hypoperfusion. This investigation proposes that OCTA assessment of retinal circulation in cases of monoclonal gammopathy could serve as a sensitive non-invasive method for detecting and monitoring early microcirculatory dysfunction resulting from heightened viscosity.