Changes in subfoveal choroidal thickness and reduction of serum levels of vascular endothelial growth factor in patients with POEMS syndrome

Yokouchi, Hirotaka; Baba, Takayuki; Misawa, Sonoko; Kitahashi, Masayasu; Oshitari, Toshiyuki; Kuwabara, Satoshi; Yamamoto, Shuichi

doi:10.1136/bjophthalmol-2016-309319

Cited by 13 publications

(13 citation statements)

References 23 publications

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“…However, vascular endothelial growth factor (VEGF) is considered to be a pivotal factor in the progressing of many clinical features [1], including papilledema. The connection between papilledema and serum VEGF has already been reported, both in our previous study and in studies of other ophthalmologists or hematologists, based on peripapillary retinal thickness (pRT) and subfoveal choroidal thickness [3][4][5][6]. But the measurements of these two parameters were inconvenient and costly, thus impractical for routine ODE assessment.…”

Section: Introductionmentioning

confidence: 82%

Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome

Liu

Zhang

Zhao

et al. 2020

Orphanet J Rare Dis

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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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Section: Introductionmentioning

confidence: 82%

Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome

Liu

Zhang

Zhao

et al. 2020

Orphanet J Rare Dis

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“…Although patients with the POEMS syndrome have been shown to have an overload of systemic extravascular fluid, e.g., peripheral oedema, pleural effusions, ascites, and pericardial effusions, the ODE and increased choroidal thickness 8,16,17 were the only structural abnormalities in the eyes.…”

Section: Discussionmentioning

confidence: 99%

“…18 We have reported that the serum level of VEGF was correlated with the subfoveal choroidal thickness. 16,17 In the choroidal vessels, serum with a high concentration of VEGF could leak into the choroidal interstitial fluid through the fenestrated choriocapillaris, and the VEGF could increase the permeability by affecting VEGFR2. It was reported from the findings in animal experiments that the blood stream reaches the axons of the optic nerve through the border tissue of Elschnig from the adjacent choroidal tissues.…”

Section: Discussionmentioning

confidence: 99%

Reduction of Optic Disc Oedema by Bortezomib and Dexamethasone Followed by Autologous Peripheral Blood Stem Cell Transplantation in Patient with POEMS Syndrome

Iwase

Yokouchi

Misawa

et al. 2017

Neuro-Ophthalmology

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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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“…Choroidal vascular hyperpermeability [35, 36] and increased serum level [51] are also considered to be associated with choroidal thickening.…”

Section: Physiology Of Choroidmentioning

confidence: 99%

Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women

Zhang

Wang

et al. 2017

Journal of Ophthalmology

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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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Changes in subfoveal choroidal thickness and reduction of serum levels of vascular endothelial growth factor in patients with POEMS syndrome

Abstract: The significant correlation between the CT and the serum level of VEGF may offer clues on the pathogenesis of ocular diseases of POEMS syndrome and on the role of serum VEGF on the choroid.

Cited by 13 publications

References 23 publications

Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome

Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome

Reduction of Optic Disc Oedema by Bortezomib and Dexamethasone Followed by Autologous Peripheral Blood Stem Cell Transplantation in Patient with POEMS Syndrome

Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women

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