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Fingolimod-associated severe bilateral cystoid macular edema
Hideki Fukuoka1, Kentaro Kojima1, Ayako Iwama1
1Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
American Journal of Ophthalmology Case Reports
|May 6, 2022
Summary
Long-term fingolimod treatment for multiple sclerosis (MS) can lead to late-onset macular edema (ME) after cataract surgery. Close monitoring is crucial for patients with MS on fingolimod post-surgery.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Fingolimod is an oral medication used for long-term treatment of multiple sclerosis (MS).
- Cataract surgery is a common procedure, but can sometimes lead to complications like macular edema (ME).
Observation:
- A 61-year-old female on long-term fingolimod for MS developed severe bilateral cystoid ME three weeks after cataract surgery.
- The patient's ME occurred four years into fingolimod treatment, with dosage tapering.
- Standard treatments for pseudophakic ME, including corticosteroid injection, were administered.
Findings:
- Macular edema (ME) resolved after 13 months of continued fingolimod treatment.
- This case highlights that severe bilateral cystoid ME can manifest years after fingolimod initiation.
Implications:
- Patients with MS on long-term fingolimod require vigilant ophthalmological follow-up after cataract surgery.
- Late-onset ME should be considered in MS patients on fingolimod presenting with visual disturbances post-operatively.
- This case underscores the importance of continued fingolimod therapy during ME management.
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