{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T15:42:38Z","timestamp":1794238958443,"version":"4.9.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To report a case of POEMS syndrome presenting with unilateral optic disc edema and unexpectedly low systemic vascular endothelial growth factor (VEGF) levels in the setting of contralateral intravitreal (IVT) anti-VEGF therapy.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A single case was reviewed.\n                    <jats:bold>Results:<\/jats:bold>\n                    A 65-year-old man with branch retinal vein occlusion in the right eye receiving IVT anti-VEGF injections presented with optic disc edema in the left eye. Systemic symptoms included skin hyperpigmentation; shortness of breath; and peripheral neuropathy characterized by numbness, tingling, swelling, and weakness of his extremities. Imaging demonstrated pachymeningeal enhancement, mixed sclerotic and lytic bone lesions, lymphadenopathy, and splenomegaly. Laboratory evaluation workup revealed a monoclonal gammopathy, and lymph node biopsy findings were consistent with the plasma cell variant of Castleman disease, supporting a diagnosis of POEMS syndrome. Notably, systemic VEGF levels were unexpectedly low (8.7 pg\/mL, normal &lt;96.2 pg\/mL), likely secondary to the IVT anti-VEGF injection.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This case highlights an atypical presentation of POEMS syndrome with unilateral disc edema and suppressed systemic VEGF levels, potentially confounded by contralateral IVT anti-VEGF treatment. Awareness of this interaction is important for accurate interpretation of VEGF levels and timely diagnosis.\n                  <\/jats:p>","DOI":"10.1177\/24741264261442951","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T12:12:05Z","timestamp":1779711125000},"page":"1353-1357","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unilateral Optic Disc Edema in the Setting of Contralateral Intravitreal Anti-VEGF Injections as the Presenting Finding in POEMS Syndrome"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-1814","authenticated-orcid":false,"given":"Marisa","family":"Tieger","sequence":"first","affiliation":[{"name":"New England Eye Center, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary C.","family":"Boulanger","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Cancer Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Yee","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Cancer Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Hartsough","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Department of Pathology, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Cestari","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Eliott","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198007000-00006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-017-0367-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/hs9.0000000000000796"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/iae.0000000000001409"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-018-1071-y"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jha2.883"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2015.29.5.357"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40942-020-00278-1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.01.019"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/iae.0000000000001493"}],"container-title":["Journal of VitreoRetinal Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264261442951","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24741264261442951","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264261442951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T04:17:28Z","timestamp":1794197848000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24741264261442951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/24741264261442951"],"URL":"https:\/\/doi.org\/10.1177\/24741264261442951","relation":{},"ISSN":["2474-1264","2474-1272"],"issn-type":[{"value":"2474-1264","type":"print"},{"value":"2474-1272","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]}}}