PURPOSE: To report a case of bilateral non-simultaneous optic neuropathy and unilateral macular edema in a patient with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. METHODS: A 61-year-old man with POEMS syndrome had bilateral anterior optic neuropathy and unilateral macular edema. RESULTS: Visual field testing showed bilateral superior altitudinal field defect. Fluorescein angiography revealed unilateral pooling of fluid consistent with cystoid macular edema. Optical coherence tomography (OCT) showed bilateral loss of retinal nerve fiber layer thickness. The erythrocyte sedimentation rate and C-reactive protein values were normal. The serum vascular growth factor measurement was elevated. CONCLUSIONS: This is the first reported case of ophthalmoscopic, angiographic, and OCT evidence of non-simultaneous optic neuropathy and macular edema in this syndrome. The increased vascular permeability could explain all these factors.
PURPOSE: To report a case of bilateral non-simultaneous optic neuropathy and unilateral macular edema in a patient with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. METHODS: A 61-year-old man with POEMS syndrome had bilateral anterior optic neuropathy and unilateral macular edema. RESULTS: Visual field testing showed bilateral superior altitudinal field defect. Fluorescein angiography revealed unilateral pooling of fluid consistent with cystoid macular edema. Optical coherence tomography (OCT) showed bilateral loss of retinal nerve fiber layer thickness. The erythrocyte sedimentation rate and C-reactive protein values were normal. The serum vascular growth factor measurement was elevated. CONCLUSIONS: This is the first reported case of ophthalmoscopic, angiographic, and OCT evidence of non-simultaneous optic neuropathy and macular edema in this syndrome. The increased vascular permeability could explain all these factors.