Bilateral non-simultaneous optic neuropathy and unilateral macular edema in a patient with POEMS syndrome.
OBJECTIVE
To report a case of bilateral non-simultaneous optic neuropathy and unilateral macular edema in a patient with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome.


METHODS
A 61-year-old man with POEMS syndrome had bilateral anterior optic neuropathy and unilateral macular edema.


RESULTS
Visual field testing showed bilateral superior altitudinal field defect. Fluorescein angiography revealed unilateral pooling of fluid consistent with cystoid macular edema. Optical coherence tomography (OCT) showed bilateral loss of retinal nerve fiber layer thickness. The erythrocyte sedimentation rate and C-reactive protein values were normal. The serum vascular growth factor measurement was elevated.


CONCLUSIONS
This is the first reported case of ophthalmoscopic, angiographic, and OCT evidence of non-simultaneous optic neuropathy and macular edema in this syndrome. The increased vascular permeability could explain all these factors.
Gutierrez-Ortiz
C
C
Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Alcalá de Henares, Madrid, Spain. consuelogutierre@gmail.com
Castro-Rebollo
M
M
Pareja
J
J
Beckford
C
C
Teus
M
M
D002199:Capillary Permeability; D005451:Fluorescein Angiography; D007839:Functional Laterality; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016878:POEMS Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D058609:Visual Field Tests; D014794:Visual Fields
C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A