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Bilateral papilledema in a patient with POEMS syndrome

Poster Details

First Author: J.Paz Moreno-Arrones SPAIN

Co Author(s):    B. Munoz Gutierrez                    

Abstract Details


Papilledema is usually secondary to intracranial hypertension, but occasionally may be the initial manifestation of systemic diseases such as POEMS syndrome, a rare pathology often found in the context of an osteogenic myeloma and other plasma cell dyscrasias.


Ophthalmology Service, Principe de Asturias University Hospital


Patient 45 who referred reduced visual acuity (VA) in both eyes(BO). He was suffered a IgM monoclonal gammopathy with secondary involvement of polyneuropathy under treatment with rituximab. In PET-CT scan performed in 2012 sclerotic lesions of 2.3 cm in left iliac bone and 1 cm in right iliac bone were observed. VA was 0.8 in BO, fundus showed a bilateral papilledema. Visual field increased blind spot was observed. Because of this episode, the patient was diagnosed of POEMS syndrome, associated with Waldestrom´s macroglobulinemia with moderate to severe mixed polyneuropathy.


Recognition of components of this syndrome (polyneuropathy, organomegaly, endocrine impairment, monoclonal gammopathy and skin changes) are the first step in managing POEMS disease.


In this syndrome hormone replacement therapy is essential .Papilloedema as the initial symptom of POEMS syndrome is rare but should be considered in the differential diagnosis of this pathology due to therapeutic implications involved.

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