Abstract
BackgroundFingolimod, an immunomodulatory agent, is used for the treatment of relapsing–remitting multiple sclerosis (RRMS). Fingolimod-associated macular edema (FAME) is a known complication with an incidence of 0.4%. The current recommendation for treatment of FAME is cessation of fingolimod. There are few case reports with management of FAME with steroid eye drops.Case presentationA 38-year-old Caucasian female patient with history of relapsing–remitting multiple sclerosis (RRMS) and treated with fingolimod developed Fingolimod-associated macular edema (FAME). Nevertheless, FAME was successfully treated with nonsteroidal anti-inflammatory eye drops without discontinuation of fingolimod.ConclusionFAME may be managed with non-steroidal eye drops without discontinuation of fingolimod in appropriate patient monitored with close follow up.
Highlights
Fingolimod, an immunomodulatory agent, is used for the treatment of relapsing–remitting multiple sclerosis (RRMS)
Fingolimod-associated macular edema (FAME) may be managed with non-steroidal eye drops without discontinuation of fingolimod in appropriate patient monitored with close follow up
Nepafenac ophthalmic suspension is a nonsteroidal, anti-inflammatory prodrug indicated for the treatment of pain and inflammation associated with cataract surgery
Summary
Fingolimod, an immunomodulatory agent, is used for the treatment of relapsing–remitting multiple sclerosis (RRMS). The most common adverse reactions (5 to 10%) are capsular opacity, decreased visual acuity, foreign body sensation, increased intraocular pressure, and sticky sensation This case describes a 38-year old female with FAME successfully controlled with nonsteroidal anti-inflammatory drops without discontinuation of fingolimod. Case presentation A 38-year-old Caucasian female with history of RRMS initiated fingolimod (0.5 mg QD) after experiencing significant disease progression with glatiramer acetate Management options for ME were discussed with the patient, including cessation of fingolimod versus starting a trial of nepafenac, a nonsteroidal anti-inflammatory drop. Since her multiple sclerosis was well-controlled with fingolimod, she was reluctant to discontinue this medication.
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