Menke et al developed a staging system to describe the hyperviscosity-related retinopathy seen in patients with Waldenstrom's macroglobulinemia. The authors are from Dana Farber Cancer Institute, Harvard Medical School and the University of Leipzig.
Parameters:
(1) retinal hemorrhages
(2) changes in the retinal veins
(3) edema at the optic nerve head
Retinal Hemorrhages
Retinal Veins
Optic Nerve Head Edema
Severity Stage
none
normal
none
1
peripheral
dilated
none
2
peripheral and central
dilated and tortuous, with "sausaging"
present
3
where:
• Peripheral hemorrhages may be dot or blotlike.
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