title: A case of POEMS syndrome with cystoid macular edema.
abstract: OBJECTIVE
  To introduce a case of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome with bilateral cystoid macular edema (CME).
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  Temporal changes of serum vascular endothelial growth factor (VEGF) levels and macular thickness were evaluated.
  
  
  RESULTS
  A 53-year-old woman with POEMS syndrome was referred complaining of long-standing impaired vision. Typical CME demonstrating petal-like dye pooling was observed in both eyes. After subtenon administrations of triamcinolone acetonide (TA), pars plana vitrectomy, and intraocular TA injection in the right eye, macular thickness decreased. Intraocular VEGF levels were <31 pg/ml at the vitrectomy and intraocular TA injection, whereas serum the VEGF level was >2000 pg/ml throughout the follow-up periods. In the untreated left eye, macular thickness altered related to serum VEGF level.
  
  
  CONCLUSIONS
  Based on the low intraocular VEGF level and serum VEGF-related change of macular thickness, elevated serum VEGF might be a cause of CME in POEMS syndrome.
authors.affiliation: Department of Organ Therapeutics, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Imai
authors.forename: Sentaro
authors.initials: S
authors.lastname: Kusuhara
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Michael Francis
authors.initials: MF
authors.lastname: Teraoka Escaño
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Tsukahara
authors.forename: Akira
authors.initials: A
authors.lastname: Negi
mesh_terms: D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008269:Macular Edema / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D014821:Vitrectomy
chemical_list: D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014222:Triamcinolone Acetonide