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Optic disc oedema in a patient with POEMS syndrome associated with Castleman's disease
F López Herrero1, J L Sánchez-Vicente1, E M Gámez-Jiménez1
1Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Abstract:
A case of POEMS syndrome associated with Castleman's disease is presented in a 36-year-old Caucasian patient, in whom papillary oedema was the neuro-ophthalmological manifestation. The patient presented with bilateral optic disc oedema, which was confirmed by optical coherence tomography, showing thickening of the retinal nerve fibre layer. Fluorescein angiography demonstrated hyperfluorescence in the early phases with mild leakage in the late phases. Visual field testing using the central 24-2 threshold strategy revealed enlargement of the blind spot in both eyes, along with an inferior arcuate defect in the left eye. Papillary oedema represents the most common manifestation of POEMS syndrome, and its association with polyneuropathy and monoclonal proteins should prompt consideration of this diagnosis.
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