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Reduction in subfoveal choroidal thickness and peripapillary retinal thickness after high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation in a patient with POEMS syndrome
Author(s) -
Hirotaka Y.,
Toshiyuki O.,
Takayuki B.,
Shuichi Y.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.0t026
Subject(s) - medicine , melphalan , poems syndrome , organomegaly , transplantation , ophthalmology , retinal , surgery , polyneuropathy
Purpose To determine whether high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation can reduce the serum level of vascular endothelial growth factor ( VEGF ), the peripapillary retinal thickness ( pRT ), and the choroidal thickness ( CT ) in a patient with the polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes ( POEMS ) syndrome. Methods A 39‐year‐old man with POEMS syndrome was given high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation. The peripapillary retinal thickness ( pRT ) and subfoveal CT was determined by spectral‐domain optical coherence tomography ( SD ‐ OCT ) to quantify the degree of optic disc edema and choroidal thickness. The pRT thickness was measured at the baseline and at 6 months after the treatment. The serum level of VEGF was also determined by enzyme‐linked immunosorbent assays ( ELISA s) at the baseline and at 6 months after beginning the treatment. Results At the baseline, the serum level of VEGF was 9960 pg/ml and the pRT was 1062 μ m in the right eye and 963 μ m in the left eye. At 6 months after the treatment, the serum level of VEGF was reduced to 333 pg/ml, the ODE was reduced bilaterally, and the pRT was decreased to 406 μ m in his right eye and 358 μ m in his left eye. The subfoveal CT was 439 μ m in the right eye and 409 μ m in the left eye at the baseline. Six months after the treatment, the subfoveal CT was decreased to 368 μ m in the right eye and 364 μ m in the left eye. Conclusions Our result showed that the peripapillary retinal thickness and subfoveal choroidal thickness were reduced in the optical coherence tomographic ( OCT ) images along with a decrease of the serum VEGF levels. We recommend OCT to monitor the changes in the signs of POEMS syndrome after treatments.