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.
- POEMS syndrome
- vascular endothelial growth factor
- peripapillary retinal thickness
- thalidomide treatment
- optic disc edema
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Contributors Design and conduct of the study: HY, TB. Collection, management, analysis and interpretation of data: HY, TB, TO, SM. Preparation, review or approval of the manuscript: HY, TB, TO, SY, SK.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval The Institutional Review Board of Chiba University Graduate School of Medicine approved the design and protocol of this study. All procedures used conformed to the tenets of the Declaration of Helsinki, and a written informed consent was obtained from each of the patients after they were informed on the purpose of this study and possible complications.
Provenance and peer review Not commissioned; externally peer reviewed.