Yokouchi Hirotaka, Baba Takayuki, Misawa Sonoko, Sawai Setsu, Beppu Minako, Kitahashi Masayasu, Oshitari Toshiyuki, Kuwabara Satoshi, Yamamoto Shuichi
Departments of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, chuo-ku, Chiba City, Chiba, 260-0856, Japan.
Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Graefes Arch Clin Exp Ophthalmol. 2015 Oct;253(10):1641-6. doi: 10.1007/s00417-014-2843-8. Epub 2014 Nov 4.
The study was conducted to determine whether serum vascular endothelial growth factor (VEGF) levels are significantly correlated with subfoveal choroidal thickness (CT) and foveal thickness (FT) in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome.
In this cross-sectional observational case series, we studied 31 eyes of 16 treatment-naïve patients with POEMS syndrome with no evidence of fundus abnormalities. Subfoveal CT and FT were measured using enhanced depth imaging optical coherence tomography (EDI-OCT), and correlations between serum VEGF levels and subfoveal CT and FT were determined.
The mean subfoveal CT was 417.9 ± 73.5 μm (right eye, 416.7 ± 81.2 μm; left eye, 419.0 ± 68.1 μm), and the mean FT was 243.8 ± 35.2 μm (right eye, 248.8 ± 22.0 μm; left eye, 239.1 ± 44.6 μm). There was a significant positive correlation between the serum VEGF level and subfoveal CT (right eye, r = 0.58, p = 0.021; left eye, r = 0.60, p = 0.012), but the correlation between the level of serum VEGF and FT was not significant (right eye, r = 0.007, p > 0.05; left eye, r = 0.25, p > 0.05).
The significant correlation between the serum VEGF level and subfoveal CT in patients with POEMS syndrome suggests that choroidal thickness is influenced by the level of serum VEGF. These results not only aid in an understanding of the pathogenesis of ocular changes in patients with POEMS syndrome, but also offer clues regarding the pathogenesis of other choroidal diseases.
本研究旨在确定多神经病、器官肿大、内分泌病、单克隆丙种球蛋白病和皮肤改变(POEMS)综合征患者的血清血管内皮生长因子(VEGF)水平是否与黄斑中心凹下脉络膜厚度(CT)及黄斑中心凹厚度(FT)显著相关。
在这个横断面观察性病例系列研究中,我们对16例初治的POEMS综合征患者的31只眼进行了研究,这些患者均无眼底异常证据。使用增强深度成像光学相干断层扫描(EDI-OCT)测量黄斑中心凹下CT和FT,并确定血清VEGF水平与黄斑中心凹下CT和FT之间的相关性。
黄斑中心凹下平均CT为417.9±73.5μm(右眼,416.7±81.2μm;左眼,419.0±68.1μm),平均FT为243.8±35.2μm(右眼,248.8±22.0μm;左眼,239.1±44.6μm)。血清VEGF水平与黄斑中心凹下CT之间存在显著正相关(右眼,r = 0.58,p = 0.021;左眼,r = 0.60,p = 0.012),但血清VEGF水平与FT之间的相关性不显著(右眼,r = 0.007,p>0.05;左眼,r = 0.25,p>0.05)。
POEMS综合征患者血清VEGF水平与黄斑中心凹下CT之间的显著相关性表明脉络膜厚度受血清VEGF水平影响。这些结果不仅有助于理解POEMS综合征患者眼部病变的发病机制,还为其他脉络膜疾病的发病机制提供线索。