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June 2013

Fingolimod-Associated Macular Edema: Resolution by Sub-Tenon Injection of Triamcinolone With Continued Fingolimod Use

Author Affiliations

Author Affiliations: School of Medicine (Ms Minuk) and Department of Ophthalmology (Drs Belliveau, Almeida, Dorrepaal, and Gale), Queen's University, Kingston, Ontario, Canada.

JAMA Ophthalmol. 2013;131(6):802-804. doi:10.1001/jamaophthalmol.2013.2465

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.13 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.

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