Author Affiliations: School of Medicine (Ms Minuk) and Department of Ophthalmology (Drs Belliveau, Almeida, Dorrepaal, and Gale), Queen's University, Kingston, Ontario, Canada.
Fingolimod (Gilenya) is an oral immunosuppressant approved for the treatment of relapsing forms of multiple sclerosis. In clinical trials, macular edema (ME) was found to be a dose-dependent adverse effect, occurring in 0.4% to 1% of patients.1 Most cases develop within 3 to 4 months of initiation and improve or resolve with discontinuation of treatment.1- 3 We describe a 58-year-old woman with bilateral fingolimod-associated ME (FAME) who was adamant that her medication be continued. We treated her successfully in both eyes with sub-Tenon triamcinolone acetonide injection without discontinuing fingolimod.
Minuk A, Belliveau MJ, Almeida DRP, Dorrepaal SJ, Gale JS. Fingolimod-Associated Macular Edema: Resolution by Sub-Tenon Injection of Triamcinolone With Continued Fingolimod Use. JAMA Ophthalmol. 2013;131(6):802-804. doi:10.1001/jamaophthalmol.2013.2465