Fingolimod-associated severe bilateral cystoid macular edema

Am J Ophthalmol Case Rep. 2022 Apr 22:26:101553. doi: 10.1016/j.ajoc.2022.101553. eCollection 2022 Jun.

Abstract

Purpose: To report a rare case in which a patient undergoing long-term oral fingolimod treatment for multiple sclerosis (MS) developed late-onset severe bilateral cystoid macular edema (ME) at 3-weeks post cataract surgery.

Observations: This study involved a 61-year-old female undergoing long-term oral fingolimod treatment for MS in whom at 4-years post initiation of treatment and the treatment being tapered to a 0.5 mg twice-weekly dose severe bilateral cystoid ME occurred at 3-weeks post cataract surgery. Although the patient was administered the proper treatments for pseudophakic ME, including a 20-mg sub-Tenon's-capsule triamcinolone acetonide injection, it took 13 months for the ME to ultimately resolve with continued oral fingolimod treatment.

Conclusions and importance: The findings in this study show that severe bilateral cystoid ME can occur even several years after initiating fingolimod treatment, thus indicating that detailed follow-up is necessary post cataract surgery.

Keywords: Bilateral macular edema; Cataract surgery; Fingolimod.

Publication types

  • Case Reports