Katharina Schröder1, David Finis2, Jens Harmel3, Marius Ringelstein4, Hans-Peter Hartung5, Gerd Geerling6, Orhan Aktas7, Rainer Guthoff8. 1. Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Katharina.Schroeder@med.uni-duesseldorf.de. 2. Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: David.Finis@med.uni-duesseldorf.de. 3. Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Jens.Harmel@med.uni-duesseldorf.de. 4. Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Marius.Ringelstein@med.uni-duesseldorf.de. 5. Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Hans-Peter.Hartung@med.uni-duesseldorf.de. 6. Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Geerling@med.uni-duesseldorf.de. 7. Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: orhan.aktas@med.uni-duesseldorf.de. 8. Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Electronic address: Rainer.Guthoff@med.uni-duesseldorf.de.
Abstract
UNLABELLED: Fingolimod is a potent drug in relapsing forms of multiple sclerosis. Visual impairment due to fingolimod-associated macular edema (FAME) usually leads to discontinuation of fingolimod therapy. METHODS: We report on a 24-year old woman with bilateral FAME. RESULTS: We continued fingolimod and added oral acetazolamide, which led to recovery of visual acuity and regression of macular edema. However, fingolimod had to be discontinued when fluorescein angiography revealed an enlarged foveal avascular zone. DISCUSSION AND CONCLUSION: Oral acetazolamide might be a treatment option for FAME, while ischemic conversion may be limiting. Ophthalmologic assessments are mandatory for follow-up when fingolimod therapy is continued after onset of FAME.
UNLABELLED: Fingolimod is a potent drug in relapsing forms of multiple sclerosis. Visual impairment due to fingolimod-associated macular edema (FAME) usually leads to discontinuation of fingolimod therapy. METHODS: We report on a 24-year old woman with bilateral FAME. RESULTS: We continued fingolimod and added oral acetazolamide, which led to recovery of visual acuity and regression of macular edema. However, fingolimod had to be discontinued when fluorescein angiography revealed an enlarged foveal avascular zone. DISCUSSION AND CONCLUSION: Oral acetazolamide might be a treatment option for FAME, while ischemic conversion may be limiting. Ophthalmologic assessments are mandatory for follow-up when fingolimod therapy is continued after onset of FAME.
Authors: Mohamed Kamel Soliman; Salman Sarwar; Mohammad A Sadiq; Loren Jack; Neil Jouvenat; Rana K Zabad; Sachin Kedar; Quan Dong Nguyen Journal: Am J Ophthalmol Case Rep Date: 2016-09-28