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

Abstract

PurposeTo 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.MethodsA 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 (ELISAs) at the baseline and at 6 months after beginning the treatment.ResultsAt the baseline, the serum level of VEGF was 9960 pg/ml and the pRT was 1062 μm in the right eye and 963 μm 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 μm in his right eye and 358 μm in his left eye. The subfoveal CT was 439 μm in the right eye and 409 μm in the left eye at the baseline. Six months after the treatment, the subfoveal CT was decreased to 368 μm in the right eye and 364 μm in the left eye.ConclusionsOur 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.