Ocular involvement in a patient with POEMS syndrome, 2 years follow‐up with OCTA

Abstract

Aims/Purpose: To report the microvascular changes in a case of POEMS syndrome over 2‐years follow‐up with OCT angiography.Methods: Case report of a 54 years old man with POEMS syndrome derived to our department from Neurology to evaluate visual acuity (VA) and fundus. OCT and OCTA (Triton, Topcon, Inc, Tokyo, Japan) was performed in each visit.Results: At the time of the first examination the patient and the VA… was 0.8 right eye (RE) and 1 left eye (LE) and fundus exploration revealed some microaneurysms (MA) and hard exudates. The OCT was normal and OCT‐A revealed some MA. In the follow‐up in 2022, the VA was 0.8 RE and 0.9 LE, in the fundus we found an increased number of MA and hard exudates, in OCT appeared some cysts in the parafoveal region and a higher number of MA in OCTA. After 2 years follow‐up, the VA was 0.9 in both eyes, and as new findings in fundus examination, some intraretinal haemorrhages and vascular proliferation in periphery in LE. In OCT persist parafoveal cysts and OCTA showed a mild increase in the number of MA. We did not found any affectation in optic nerve or signs of vasculitis.Conclusions: POEMS syndrome is a multiorganic disease with an increase production of vascular endothelial growth factor (VEGF). The ocular involvement is rare and the more common findings are optic neuropathy, macular oedema or retinal occlusive vasculitis. In this case report we made a follow‐up in the changes in OCT and OCTA. These two ancillary tests help to found microvascular changes that can be unnoticed in these patients. As far as we know, there is not others publications with a 2 years follow‐up with OCTA in POEMS syndrome.