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Zhang X, Wang H, Zhang K, Ma J, He H, Song S, Shao E, Chen B, Yang J, Zhao X, Sui W, Wang M, Liu S, Guo X, Zhu H, Yao Y, Zhong Y, Xing B. Blood Glucose Levels Moderate the Associations Between IGF-1 Levels and Choroidal Metrics in Patients With Diabetes With Acromegaly Without Diabetic Retinopathy. Transl Vis Sci Technol 2024; 13:20. [PMID: 39078643 PMCID: PMC11290567 DOI: 10.1167/tvst.13.7.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/21/2024] [Indexed: 07/31/2024] Open
Abstract
Purpose To examine the effects of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) on choroidal structures with different blood glucose levels in patients with diabetes mellitus (DM) with acromegaly without diabetic retinopathy. Methods Eighty-eight eyes of 44 patients with acromegaly were divided into a nondiabetic group (23 patients, 46 eyes) and a diabetic group (21 patients, 42 eyes). Forty-four age- and sex-matched healthy controls and 21 patients with type 2 DM without diabetic retinopathy were also included. Linear regression models with a simple slope analysis were used to identify the correlation and interaction between endocrine parameters and choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascular index (CVI). Results Our study revealed significant increases in the ChT, LA, SA, and TCA in patients with acromegaly compared with healthy controls, with no difference in the CVI. Comparatively, patients with DM with acromegaly had greater ChT than matched patients with type 2 DM, with no significant differences in other choroidal parameters. The enhancement of SA, LA and TCA caused by an acromegalic status disappeared in patients with diabetic status, whereas ChT and CVI were not affected by the interaction. In the diabetic acromegaly, higher IGF-1 (P = 0.006) and GH levels (P = 0.049), longer DM duration (P = 0.007), lower blood glucose (P = 0.001), and the interaction between GH and blood glucose were associated independently with thicker ChT. Higher GH levels (P = 0.016, 0.004 and 0.007), longer DM duration (P = 0.022, 0.013 and 0.013), lower blood glucose (P = 0.034, 0.011 and 0.01), and the interaction of IGF-1 and blood glucose were associated independently with larger SA, LA, and TCA. As blood glucose levels increased, the positive correlation between serum GH level and ChT diminished, and became insignificant when blood glucose was more than 7.35 mM/L. The associations between serum IGF-1 levels and LA, SA, and TCA became increasingly negative, with LA, becoming significantly and negatively associated to the GH levels only when blood glucose levels were more than 8.59 mM/L. Conclusions Acromegaly-related choroidal enhancements diminish in the presence of DM. In diabetic acromegaly, blood glucose levels are linked negatively with changes in choroidal metrics and their association with GH and IGF-1. Translational Relevance We revealed the potential beneficial impacts of IGF-1 and GH on structural measures of the choroid in patients with DM at relatively well-controlled blood glucose level, which could provide a potential treatment target for diabetic retinopathy.
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Affiliation(s)
- Xia Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Heng Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Zhang
- Chongqing Chang'an Industrial Group Co., Ltd, Chongqing, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Song
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Enhua Shao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science of Technology, Wuhan, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenda Sui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sihua Liu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaopeng Guo
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Yao
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bing Xing
- Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yokouchi H, Nagasato D, Mitamura Y, Egawa M, Tabuchi H, Misawa S, Kuwabara S, Baba T. Alterations in choroidal vascular structures due to serum levels of vascular endothelial growth factor in patients with POEMS syndrome. Sci Rep 2023; 13:10650. [PMID: 37391497 PMCID: PMC10313687 DOI: 10.1038/s41598-023-37727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/27/2023] [Indexed: 07/02/2023] Open
Abstract
A higher serum vascular endothelial growth factor (VEGF) level can cause choroidal thickening in the choroid of patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We aimed to determine whether fluctuations in serum VEGF levels affect choroidal vascular structures in patients with POEMS syndrome. This retrospective observational case series examined 17 left eyes of 17 patients with POEMS syndrome. Enhanced depth imaging optical coherence tomography (EDI-OCT) images were obtained, and serum VEGF levels were measured at baseline and 6 months after transplantation with dexamethasone (n = 6), thalidomide (n = 8), or lenalidomide (n = 3). EDI-OCT images were binarized using ImageJ software, and we calculated the areas of the whole choroid and the luminal and stromal areas. Subsequently, we determined whether the choroidal vascular structure had changed significantly between baseline and 6 months after treatment. Six months after treatment, serum VEGF levels and the whole choroid, luminal, and stromal areas had decreased significantly compared to the baseline values (all, P < 0.001). The mean luminal area to the whole choroidal area ratio at 6 months after treatment was 0.70 ± 0.03, which was significantly smaller than the ratio at baseline (0.72 ± 0.03; P < 0.001). Whole choroid and luminal area fluctuations were significantly positively correlated with fluctuations in serum VEGF levels (r = 0.626, P = 0.007 and r = 0.585, P = 0.014, respectively). Choroidal thickening induced by VEGF might be caused by increases in the choroidal vessel lumen area. These results may offer insights into the pathogenesis of POEMS syndrome and the role of serum VEGF in choroidal vascular structure, which may apply to other ocular diseases.
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Affiliation(s)
- Hirotaka Yokouchi
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-7-1, Inohana, Chiba, 260-0856, Japan.
| | - Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mariko Egawa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Sonoko Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-7-1, Inohana, Chiba, 260-0856, Japan
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Zhou XL, Chang YH, Li L, Ren J, Wu XL, Zhang X, Wu P, Tang SH. Polyneuropathy organomegaly endocrinopathy M-protein and skin changes syndrome with ascites as an early-stage manifestation: A case report. World J Clin Cases 2023; 11:135-142. [PMID: 36687199 PMCID: PMC9846972 DOI: 10.12998/wjcc.v11.i1.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/04/2022] [Accepted: 12/09/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor. The clinical manifestations of POEMS syndrome are diverse. Due to the insidious onset and lack of specific early-stage manifestations, POEMS syndrome is easily misdiagnosed or never diagnosed, leading to delayed treatment. Neurological symptoms are usually the first clinical manifestation, while ascites is a rare symptom in patients with POEMS syndrome.
CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom, which is a rare early-stage manifestation of the condition. After 1 year, the patient gradually developed progressive renal impairment, anemia, polyserosal effusion, edema, swollen lymph nodes on the neck, armpits, and groin, and decreased muscle strength of the lower extremities. The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion. Treatment comprised bortezomib + dexamethasone, continuous renal replacement therapy, chest and abdominal closed drainage, transfusions of erythrocytes and platelets, and other symptomatic and supportive treatments. The patient’s condition initially improved after treatment. However, then her symptoms worsened, and she succumbed to the illness and died.
CONCLUSION Ascites is a potential early manifestation of POEMS syndrome, and this diagnosis should be considered for patients with unexplained ascites. Furthermore, multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.
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Affiliation(s)
- Xiao-Lei Zhou
- Graduate School, Southwest Medical University, Luzhou 646099, Sichuan Province, China
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Ying-Hao Chang
- Department of Infectious Diseases, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Lan Li
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Juan Ren
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Xiao-Ling Wu
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Xue Zhang
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Peng Wu
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Shan-Hong Tang
- Graduate School, Southwest Medical University, Luzhou 646099, Sichuan Province, China
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
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Abstract
PURPOSE To report a 67-year-old woman with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome, showing bilateral serous retinal detachment. The retinal lesion was evaluated by multimodal imaging using spectral domain optical coherence tomography and an adaptive optics (AO) camera. METHODS A case report. RESULTS Optical coherence tomography showed hyperreflective foci mainly in the inner retina in both eyes. The AO images showed many low-reflective dots in the right eye. Three months after hematological treatment, both hyperreflective foci in the optical coherence tomography images and the low-reflective dots in the AO images disappeared. CONCLUSION Low-reflective dots were detected in AO images of eyes with serous retinal detachment secondary to POEMS syndrome. AO cameras can detect retinal microstructures in living eyes.
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Lyzogubov V, Dasso M, Bora N, Bora PS. Role of thalidomide, senicapoc, and sodium butyrate in choroidal neovascularization. Biochem Biophys Res Commun 2020; 530:367-373. [PMID: 32800337 DOI: 10.1016/j.bbrc.2020.07.140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023]
Abstract
Choroidal neovascularization (CNV) is the hallmark of wet age-related macular degeneration (AMD), a leading cause of irreversible blindness in the modern world. The objective for this study was to investigate the therapeutic potential of known antiangiogenic agents: thalidomide, senicapoc, and sodium butyrate. Dose-dependent effect of the agents on growth of ARPE-19 cells and human umbilical vein endothelial cells (HUVECs) was investigated with cell counting assays. Half-maximal inhibitory concentrations of thalidomide (765 μM and 1520 μM), senicapoc (50 μM and 79 μM), and sodium butyrate (933 μM and 557 μM) were determined for HUVECs and ARPE-19 cells, respectively. Immunofluorescence analysis showed decrease of VEGFA expression in both ARPE-19 cells and HUVECs after treatment only with thalidomide but not with senicapoc or sodium butyrate. Efficacy of the agents was studied in vivo with laser-induced CNV in C57BL/6 mice. Thalidomide (24 μg), senicapoc (4 μg), or sodium butyrate (100 μg) was intravitreally injected the day after CNV induction. Thalidomide, senicapoc, and sodium butyrate inhibited CNV size by 56%, 24%, and 21% respectively on day 7 post-laser. Thalidomide also reduced cobalt chloride induced increase of VEGFA mRNA in ARPE-19 (-33%) and protein in culture medium (-20%). Our results suggest that thalidomide may have more therapeutic potential than senicapoc or sodium butyrate for treatment of CNV or wet AMD.
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Affiliation(s)
- Valeriy Lyzogubov
- Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center and College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA.
| | - Michael Dasso
- Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center and College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA.
| | - Nalini Bora
- Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center and College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA.
| | - Puran S Bora
- Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center and College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA.
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Liu LS, Zhang X, Zhao H, Gao XM, Zhou DB, Dai RP, Li J. Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome. Orphanet J Rare Dis 2020; 15:116. [PMID: 32429967 PMCID: PMC7238582 DOI: 10.1186/s13023-020-01392-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/04/2020] [Indexed: 12/25/2022] Open
Abstract
Background Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome involving multisystem. Optic disc edema (ODE) is the most common ocular manifestation in patients with POEMS syndrome and serves as an independent prognostic factor. However, parameters previously used to estimate its severity were inconvenient and costly. This study was designed to bring forward a novel and practical parameter, optic disc edema area, to evaluate ODE in patients with this disease and applied it to assess effectiveness of lenalidomide combined with dexamethasone in respect of ODE. Results Forty-one treatment-naive patients with POEMS syndrome were enrolled in this single-center prospective study and treated with lenalidomide combined with dexamethasone. They received ocular examination to determine optic disc edema (ODE) area and other optic manifestations. Meanwhile, serum VEGF was measured before and after treatment. Among 41 enrolled patients, 38 received complete ocular examinations, and 25 of which had ODE at initial visit. Binocular mean ODE area of patients with ODE was significantly related to ODE grade (r = 0.620, p = 0.003) and peripapillary retinal thickness (r = 0.760, p < 0.001) before treatment. Serum VEGF was significantly higher in patients with ODE than their counterparts (p = 0.025) and positively correlated with binocular mean ODE area (r = 0.460, p = 0.036). After treatment, ODE area, along with serum VEGF, decreased markedly (p < 0.001). Conclusion ODE area was a reliable index to evaluate ODE severity and could precisely reflect ODE improvement through systemic treatment. Additionally, it was related to serum VEGF, a key factor in disease pathogenesis, suggesting its potential as an indicator of the overall severity of this disease. Trial registration Clinicaltrials, NCT01816620. Registered March 222,013.
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Affiliation(s)
- Ling-Shan Liu
- Eight-year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao Zhang
- Department of Ophthalmology and Key Laboratory of Ocular Fundus Diseases
- , Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Hao Zhao
- Department of Hematology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xue-Min Gao
- Department of Hematology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Rong-Ping Dai
- Department of Ophthalmology and Key Laboratory of Ocular Fundus Diseases
- , Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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Ortiz Zapata A, Cárdenas PL, Acuña MF, Peralta Álvarez M, Ortiz Zapata J, Pizarro Imaicela B. Neuro-ophthalmological manifestations of POEMS syndrome. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2019; 94:495-499. [PMID: 31311688 DOI: 10.1016/j.oftal.2019.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 05/20/2019] [Indexed: 06/10/2023]
Abstract
The cases is presented of a 38 year-old male with a constitutional syndrome, fever, multiple swollen lymph nodes, and hepatosplenomegaly of 2 months onset. There was also mention of headache, bilateral blurred vision, and myiodesopsias. Best correct visual acuity was 20/50 and 20/200. The anterior segment was unremarkable. The fundus of both eyes showed raised and erased discs, accompanied by serous detachment, greater in the left eye. Complementary studies of both eyes showed a visual field with increased blind spot; fluorescein angiography indicated late disc hyperfluorescence. The electroretinogram showed compromise of cones and rods, and the visual evoked potential detected alteration in the perception and conduction of stimuli. The imaging studies were essentially normal. During his hospital admission he presented with paraparesis, renal failure, endocrinopathy, skin alterations, and osteoblastic lesions with negative biopsies. Monoclonal gammopathy was documented, and the diagnosis of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes) syndrome was made. The chemotherapy started with dexamethasone/melphalan, with a good response at 3 months.
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Affiliation(s)
- A Ortiz Zapata
- Centro de Especialidades Oftalmológicas ALJAORZA (CEOA), Machala, Ecuador.
| | - P L Cárdenas
- Fundación Oftalmológica de Santander, Clínica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | - M F Acuña
- Fundación Oftalmológica de Santander, Clínica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | | | - J Ortiz Zapata
- Centro de Especialidades Oftalmológicas ALJAORZA (CEOA), Machala, Ecuador
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Yokouchi H, Baba T, Misawa S, Oshitari T, Kuwabara S, Yamamoto S. Correlation of changes in serum level of VEGF and peripapillary retinal thickness in patients with POEMS syndrome. Br J Ophthalmol 2019; 104:33-38. [PMID: 30914422 DOI: 10.1136/bjophthalmol-2018-313703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 11/03/2022]
Abstract
AIM To determine whether changes in the serum levels of vascular endothelial growth factor (VEGF) after thalidomide therapy will affect the peripapillary retinal thickness (pRT) associated with optic disc oedema (ODE) in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome. METHODS This was a retrospective, observational case series of 23 right eyes of 23 treatment-naïve patients with POEMS syndrome and ODE whose intracranial pressure was within the normal range. The pRT was determined by spectral-domain optical coherence tomography, and the serum level of VEGF was determined by ELISA at baseline and 6 months after the thalidomide therapy. We determined whether a change in the pRT from baseline was significantly correlated with the serum level of VEGF from that at 6 months after the thalidomide treatment. RESULTS Six months after treatment, the mean serum level of VEGF was significantly reduced from 7153±4214 pg/mL to 1067±769 pg/mL (p<0.001), and the pRT was significantly decreased from 471.2±203 µm to 318.1±53.9 µm (p<0.001). The change in the pRT from baseline was significantly and linearly correlated with the change in the serum level of VEGF from that at 6 months after treatment (r=0.67, p=0.00039). CONCLUSIONS The close relationship between the pRT and the serum level of VEGF may offer clues on the pathogenesis of POEMS syndrome and potentially add a new candidate cause for the pathogenesis of ODE.
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Affiliation(s)
- Hirotaka Yokouchi
- Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takayuki Baba
- Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sonoko Misawa
- Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshiyuki Oshitari
- Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoshi Kuwabara
- Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shuichi Yamamoto
- Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
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Zhang J, Wang H, Yu Q, Tong Q, Lu Q. Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women. J Ophthalmol 2017; 2017:8296574. [PMID: 28630765 PMCID: PMC5463124 DOI: 10.1155/2017/8296574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/18/2017] [Indexed: 12/28/2022] Open
Abstract
The body changes markedly during pregnancy; each system behaves differently from a nonpregnant state. As the eyes are the only windows to see directly what is going on in the internal environment, more and more researches have been done to explain the association between ocular changes and the physiological and pathological changes during pregnancy. The choroid is one of the critical parts of the eye, providing nutrition. And abnormal choroid may result in ocular dysfunction and visual problems. As the optical coherence tomography develops, a rapid, direct, noninvasive, and nontoxic way is available to obtain the choroid situation of pregnant women, which may explain the mechanism of pregnancy-related eye diseases. This review would summarize relevant original articles published from January 1, 2008 to December 1, 2016 to assess the changes of choroidal thickness (CT) with enhanced depth imaging optical coherence tomography (EDI-OCT) during pregnancy. And the relationship between choroidal thickness changes and pregnancy remains uncertain. To our knowledge, this is the first review of EDI-OCT in assessing the choroidal thickness of the pregnant women.
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Affiliation(s)
- Jun Zhang
- Medical School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang, China
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Huiyun Wang
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qiubo Yu
- Department of Obstetrics, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qihu Tong
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qinkang Lu
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
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Iwase T, Yokouchi H, Misawa S, Oshitari T, Baba T, Kuwabara S, Yamamoto S. Reduction of Optic Disc Oedema by Bortezomib and Dexamethasone Followed by Autologous Peripheral Blood Stem Cell Transplantation in Patient with POEMS Syndrome. Neuroophthalmology 2017; 42:25-30. [PMID: 29467805 DOI: 10.1080/01658107.2017.1318406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/12/2017] [Accepted: 04/08/2017] [Indexed: 01/15/2023] Open
Abstract
The authors present findings in a 39-year-old man with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome with bilateral optic disc oedema. He was successfully treated with bortezomib and dexamethasone followed by autologous peripheral blood stem cell transplantation. The peripapillary retinal thickness was reduced in the optical coherence tomographic (OCT) images along with a decrease of the serum vascular endothelial growth factor (VEGF) levels. The authors recommend OCT to monitor the changes in the signs of POEMS syndrome after treatments.
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Affiliation(s)
- Takehito Iwase
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hirotaka Yokouchi
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sonoko Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshiyuki Oshitari
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shuichi Yamamoto
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, Chiba, Japan
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