Improvement in visual acuity and retinal phenotype with intravitreal aflibercept (anti-VEGF) in POEMS syndrome with Castleman disease variant

Abstract

A woman in her thirties with no ophthalmic history presented two days of flashes and floaters. She had reduced right-eye visual acuity, bilateral retinal hemorrhages, and papilledema. She was diagnosed with polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes (POEMS) syndrome with Castleman disease variant, with elevated systemic levels of vascular endothelial growth factor (VEGF). Three doses of aflibercept (VEGF blocker) were administered to the right eye. The right eye improved from 6/60 to 6/5 after treatment. We suggest that intravitreal VEGF blockade should be considered to preserve vision in patients with POEMS syndrome and high circulating VEGF.