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Int. J. Mol. Sci. 2016, 17(12), 2106; doi:10.3390/ijms17122106

Fingolimod Associated Bilateral Cystoid Macular Edema—Wait and See?

1
Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
2
Private Ophthalmology Office, 30851 Langenhagen, Germany
3
Department of Ophthalmology, Hannover Medical School, 30625 Hannover, Germany
4
Department of Neurology, University of Duisburg-Essen, 45147 Essen, Germany
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Sven Meuth
Received: 29 July 2016 / Accepted: 7 December 2016 / Published: 14 December 2016
(This article belongs to the Special Issue Advances in Multiple Sclerosis 2016)
View Full-Text   |   Download PDF [18937 KB, uploaded 14 December 2016]   |  

Abstract

Fingolimod 0.5-mg once-daily is an approved therapy for patients with relapsing–remitting multiple sclerosis (MS). Several pivotal and real-world studies have demonstrated that fingolimod is associated with the development of macular edema (ME). Herein, we present a case of a diabetic MS patient who developed severe bilateral ME during fingolimod treatment. By means of this case study we provide a detailed review about fingolimod associated macular edema (FAME), its current incidence with or without diabetes mellitus, and previous therapy attempts and outcomes in MS patients. Intravitreal administration of antibodies raised against vascular endothelial growth factor A (VEGF-A) has not yet been used in the management of FAME, however, the excellent therapeutic response in our patient may justify the use of anti-VEGF-A agents in combination with cessation of fingolimod to achieve fast resolution of FAME and to prevent visual deficits, particularly in bilateral FAME. View Full-Text
Keywords: multiple sclerosis; fingolimod; macular edema; VEGF; diabetes mellitus multiple sclerosis; fingolimod; macular edema; VEGF; diabetes mellitus
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Pul, R.; Osmanovic, A.; Schmalstieg, H.; Pielen, A.; Pars, K.; Schwenkenbecher, P.; Sühs, K.W.; Yildiz, Ö.; Frank, B.; Stangel, M.; Skripuletz, T. Fingolimod Associated Bilateral Cystoid Macular Edema—Wait and See? Int. J. Mol. Sci. 2016, 17, 2106.

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