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Simone Kellner, Sonja Slowik, Mahmoud Mokhtar Elhelbawi, Silke Weinitz, Ghazaleh Farmand, Ulrich Kellner; Acute Fingolimod Associated Macular Edema 2 Days After Onset Of Treatment And Gradual Resolution Under Ketorolac Therapy Over 5 Months. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3151.
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Fingolimod associated cystoid macular edema (CME) has been reported previously. Whereas in most cases CME develops after a treatment period of about 4 months, onset within a week after treatment with fingolimod has been reported. Here we report the findings in a patient with acute onset of fingolimod associated bilateral cystoid macular edema (CME) after 2 days with prolonged duration of improvement after immediate cessation of fingolimod therapy.
Patient history, clincial examination and repeated spectral domain OCT were performed over a period of 5 months.
A 53 year old male patient presented with acute onset of bilateral marked CME 2 daxs after initiation of fingolimod therapy. Visual acuity was normal at an examination 4 years earlier and was reduced to 0.3 (RE) and 0.2 (LE) at initial examination. Marked CME was demonstrated with spectral domain OCT. No other causes of CME were revealed with patient or family history, angiography, fundus or near-infrared autofluorescence. Over a period of 5 month a gradual decline of CME occured after immediate cessation of fingolimod therapy and under local ketorolac application. After 5 months, an almost complete resolution of CME occured and visual acuity had recovered to 1.0.
Fingolimod associated CME can occur even after two days of treatment and may take a long time for resolution.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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