Fingolimod-associated severe bilateral cystoid macular edema

Fukuoka, Hideki; Kojima, Kentaro; Iwama, Ayako; Okumura, Takahiro; Sotozono, Chie

doi:10.1016/j.ajoc.2022.101553

Cited by 3 publications

(7 citation statements)

References 8 publications

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“…The occurrence of cystoid macular edema has been observed and linked to fingolimod use. A 61-year-old female suffering from multiple sclerosis and on chronic use of fingolimod for four years suddenly developed bilateral cystoid macular edema within three weeks of cataract surgery [ 35 ]. The blurring of vision was initially reported in the left eye and, after two weeks, proceeded to the right eye [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

“…A 61-year-old female suffering from multiple sclerosis and on chronic use of fingolimod for four years suddenly developed bilateral cystoid macular edema within three weeks of cataract surgery [ 35 ]. The blurring of vision was initially reported in the left eye and, after two weeks, proceeded to the right eye [ 35 ]. Treatment was started, along with the continuation of fingolimod to prevent the worsening of multiple sclerosis, and the edema was resolved after 13 months [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

“…The blurring of vision was initially reported in the left eye and, after two weeks, proceeded to the right eye [ 35 ]. Treatment was started, along with the continuation of fingolimod to prevent the worsening of multiple sclerosis, and the edema was resolved after 13 months [ 35 ]. The study highlights the importance of carefully monitoring postoperative patients after cataract surgery, as fingolimod's adverse effects can occur many years later [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

“…Treatment was started, along with the continuation of fingolimod to prevent the worsening of multiple sclerosis, and the edema was resolved after 13 months [ 35 ]. The study highlights the importance of carefully monitoring postoperative patients after cataract surgery, as fingolimod's adverse effects can occur many years later [ 35 ]. A 60-year-old female suffering from diabetes also developed cystoid macular edema 10 days after initiation of treatment, and symptoms resolved after discontinuing the drug [ 36 ].…”

Section: Reviewmentioning

confidence: 99%

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Fingolimod-Associated Macular Edema in the Treatment of Multiple Sclerosis

Khan,

Gutlapalli,

Sohail

et al. 2023

Cureus

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Multiple sclerosis is a neurological disorder categorized by inflammatory processes with a high prevalence worldwide. It affects both motor and sensory pathways and is also associated with the visual pathway. Fingolimod is a commonly used drug for relapsing-remitting multiple sclerosis. It is a sphingosine 1-phosphate modulator acting on its receptors for immune cell accumulation, neuronal function, embryological development, vascular permeability, smooth muscle cell function, and endothelial barrier maintenance. This review aims to understand the processes, mechanisms, risks, and management of fingolimod-associated macular edema. Due to the anti-inflammatory properties of fingolimod, it decreases various cytokines, including interleukin (IL)-1B and IL-6, spike wave, and spike amplitude, in electrophysiological activities and decreases insoluble receptors for advanced glycation end product ligand. A daily dosage of 0.5 mg of fingolimod has an increased association with macular edema. The serious adverse events of fingolimod are lymphopenia, cardiovascular events, ocular events, and carcinoma. Fingolimod decreases brain volume and increases vascular permeability, resulting in increased macular volume and damage to the blood-retinal barrier, which causes an increased risk for macular edema. Cystoid macular edema is more common in older individuals suffering from comorbidities affecting the retina, such as diabetes, or those undergoing ophthalmological surgeries. This review also highlights the importance of regular ophthalmology examinations on patients consuming fingolimod both in the initial stages and chronic use. The treatment options for macular edema include nonsteroidal anti-inflammatory drugs, acetazolamide, triamcinolone, ketorolac, corticosteroids, and intravitreal procedures.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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Fingolimod-Associated Macular Edema in the Treatment of Multiple Sclerosis

Khan,

Gutlapalli,

Sohail

et al. 2023

Cureus

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“…[65] Fingolimod kullanımı ile ilişkili makuler ödem gelişimini bildiren çok sayıda rapor bulunmaktadır. [66,67] Fingolimod henüz bilinmeyen bir mekanizma ile kan-retina bariyerini yıkarak ve vasküler geçirgenliği artırarak makuler ödem oluşumuna neden olmaktadır. [68] Amerikan İlaç ve Gıda Ajansı (FDA) fingolimod kullanan hastalarda oküler bulguların yakından takibini önermektedir.…”

Section: Epinefrinunclassified

Drugs Causing Cystoid Macular Edema: Pathogenesis, Diagnosis, and Treatment

2023

Güncel Retina (Current Retina)

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Cystoid macular edema (CME) is a disorder that usually develops in association with ocular pathologies or systemic diseases. Various topical or systemic drugs are also known to lead to the formation of cystoid macular edema. Anti-hyperlipidemic drug niacin (nicotinic acid), antineoplastic agents taxanes (paclitaxel/docetaxel), oral antidiabetic drugs glitazones, iron, and aluminum chelator deferoxamine, and fingolimod used in the treatment of multiple sclerosis are drugs used systemically and shown to be associated with macular edema. In addition, epinephrine and prostaglandin analogs are ocular agents known to be associated with CME. The purpose of this article is to provide an overview of the available scientific evidence on the development of drug-induced cystoid macular edema and to provide insight into possible pathophysiological mechanisms and therapeutic approaches.

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Fingolimod/triamcinolone

2022

Reactions Weekly

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Fingolimod-associated severe bilateral cystoid macular edema

Cited by 3 publications

References 8 publications

Fingolimod-Associated Macular Edema in the Treatment of Multiple Sclerosis

Fingolimod-Associated Macular Edema in the Treatment of Multiple Sclerosis

Drugs Causing Cystoid Macular Edema: Pathogenesis, Diagnosis, and Treatment

Fingolimod/triamcinolone

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