Papiledema asociado a síndrome de POEMS

Abstract

The most common ophthalmological pathology in POEMS syndrome is papilledema, the etiology of which could be infiltrative, intracranial hypertension, inflammation or an increase of the vascular permeability. The correct diagnosis and treatment of papilledema, depending on its etiology, should permit an acceptable visual outcome to be achieved.

Paraneoplastic and non-paraneoplastic retinopathy and optic neuropathy: Evaluation and management

“…Visual field testing usually demonstrates enlargement of the blind spot, 125,291 although arcuate defects are also described. 24,52,94 FA typically shows late optic disk leakage and may also demonstrate petaloid leakage consistent with CME. OCT may also confirm the presence of CME or macular detachment.…”

POEMS (polyneuropathy, organomegaly, endocrinopathy, M‐protein and skin changes) syndrome in China

“…Papilloedema might be asymptomatic or might cause headache, transient obscurations of vision, scotomata, enlarged blind spots, or progressive constriction of the visual field. 5,14 The sign cannot be ignored in POEMS syndrome in China.…”

Ocular complications of plasma cell dyscrasias

“…Additional case reports have been published to substantiate the relationship between papilledema as an initial presenting symptom and POEMS Syndrome for patients between 16 and 62 years. [134][135][136][137][138][139][140] The same studies have also outlined the presence of cystic macular edema (CME). [138][139][140][141] The etiology of ODE is thought to be elevated intracranial pressure and CSF protein, increased vascular permeability due to cytokines, inflammation (vasculitis), and infiltration.…”

“…[138][139][140][141] The etiology of ODE is thought to be elevated intracranial pressure and CSF protein, increased vascular permeability due to cytokines, inflammation (vasculitis), and infiltration. 130,136 Decreased visual acuity is another common presentation in conjunction with ODE, blurred vision, enlarging blind spot, retinal detachment, floaters, disc hyperfluorescence, altered visual evoked potential, photopsia, central retinal artery occlusion, chalky white optic disc, and choroidal filling defects. [142][143][144][145][146] In a prior case report, Barry and colleagues detected a progressively enlarging blind spot in addition to ODE, which vastly improved with oral steroid therapy.…”

“…138–141 The etiology of ODE is thought to be elevated intracranial pressure and CSF protein, increased vascular permeability due to cytokines, inflammation (vasculitis), and infiltration. 130,136…”