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Katsuya Yagisawa, Hirotaka Yokouchi, Takehito Iwase, Takayuki Baba, Shuichi Yamamoto; Differences in treatment outcomes is related to degree of peripapillary retinal thickness in patients with POEMS syndrome. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6703.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether the peripapillary retinal thickness (pRT), serum VEGF level, grip strength, and compound muscle action potentials (CMAP) in the upper limb before and after treatment were related to the outcome in patients with the polineuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome.
This was a retrospective study of the medical records of 16 patients with the POEMS syndrome conducted between 2014 to 2017. The patients were treated with autologous peripheral blood stem cell transplantation or thalidomide and were monitored for at least 12 months after the treatment. The pRT was measured by optical coherence tomography (OCT; RS3000 advance, NIDEK) before and after the treatment. The patients were divided into two groups according to the pRT before treatment; Group A, pRT>350 µm and Group B, pRT <350 µm. The change of the serum VEGF level, grip strength, and CMAP at 6 months and 12 months after treatment was determined by the Mann-Whitney test. The serum VEGF level was measured by enzyme-linked immunosorbent assay.
There was no significant difference between the two groups in the change of the serum VEGF level at both 6 months (P=0.35) and 12 months (P=0.54) after either treatment. The differences between the two groups in the change of the grip strength (P=0.14) and CMAP (P=0.09) at 6 months after treatment was not significant. However, there was a significant difference between the two groups in the change of the grip strength (P=0.028) and CMAP (P=0.045) at 12 months after the treatment.
The significant improvement of the grip strength and CMAP in the patients whose pre-treatment pRT was >350 µm suggests that the pre-treatment pRT might be a predictive marker for the efficacy of treatment in patients with the POEMS syndrome.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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