Effects of systemic fingolimod treatment on anterior segment parameters and tear film functions

To investigate the potential effects of systemic fingolimod treatment on parameters of the anterior segment of the eye and tear film function tests in patients with multiple sclerosis (MS).

Forty-eight eyes of 24 individuals who were started on systemic fingolimod treatment for relapsing-remitting MS were prospectively enrolled in this study. Patients underwent examinations immediately before initiation of systemic fingolimod treatment, and at the first and sixth months of treatment. Anterior segment parameters were measured using Sirius Topography. The Schirmer-I test and tear break-up time (TBUT) were recorded during follow-up. Retinal thickness was also analyzed using spectral-domain optical coherence tomography (SD-OCT).

There was no statistically significant difference in retinal thickness measurements between follow-up visits. The central corneal thickness, keratometric values, anterior chamber depth, aqueous humor depth, iridocorneal angle, horizontal anterior chamber tilt and anterior chamber volume values remained similar during follow-up. The Schirmer-I test value was 15.10 ± 2.65 mm at the zeroth month and 17.03 ± 3.61 mm at the sixth month (p = 0.044). The mean TBUT was significantly higher at the six-month visit compared to baseline and the one-month visit (p_0-6 < 0.001, p_1-6 < 0.001), but there was no statistically significant difference between baseline and month 1 (p_0-1 = 0.419).

Systemic use of fingolimod may increase Schirmer I test and TBUT values in MS patients without altering other anterior segment parameters within 6 months.