Fingolimod therapy and macular hemorrhage.

Abstract

A 54-year-old woman with relapsing-remitting multiple sclerosis (MS) developed visual loss in her left eye due to a macular hemorrhage 11 months after starting fingolimod. Visual acuity was 20/80 in the left eye, with a dense retinal hemorrhage involving the fovea with adjacent hard exudate and macular thickening confirmed by spectral domain optical coherence tomography. Three months after stopping fingolimod, vision in the left eye improved to 20/30 with resolution of the macular hemorrhage and exudates. Fingolimod has been associated with macular edema, but prior to this report, the authors are unaware of it causing a macular hemorrhage in a MS patient. The authors speculate that the macular hemorrhage may be due to a disruption of cellular adhesions between vascular endothelial cells that maintain the inner blood-retinal barrier.

• Authors: M Tariq Bhatti, S Mitchell Freedman, Tamer H Mahmoud
• Journal: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society (J Neuroophthalmol) Vol. 33 Issue 4 Pg. 370-2 (Dec 2013) ISSN: 1536-5166 [Electronic] United States
• PMID: 23845997 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Immunosuppressive Agents
• Propylene Glycols
• Fingolimod Hydrochloride
• Sphingosine

Topics

• Blindness (etiology)
• Female
• Fingolimod Hydrochloride
• Fluorescein Angiography
• Hemorrhage (drug therapy, etiology, pathology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Macula Lutea (pathology)
• Middle Aged
• Multiple Sclerosis, Relapsing-Remitting (complications)
• Propylene Glycols (therapeutic use)
• Sphingosine (analogs & derivatives, therapeutic use)
• Tomography, Optical Coherence