Departments of Ophthalmology (MTB, THM) and Medicine (Division of Neurology) (MTB), Duke Eye Center and Duke University Medical Center, Durham, North Carolina; and Raleigh Neurology Associates, PA (SMF), Raleigh, North Carolina.
J Neuroophthalmol. 2013 Dec;33(4):370-2. doi: 10.1097/WNO.0b013e31829b42e1.
A 54-year-old woman with relapsing-remitting multiple sclerosis (MS) developed visual loss in her left eye due to a macular hemorrhage 11 months after starting fingolimod. Visual acuity was 20/80 in the left eye, with a dense retinal hemorrhage involving the fovea with adjacent hard exudate and macular thickening confirmed by spectral domain optical coherence tomography. Three months after stopping fingolimod, vision in the left eye improved to 20/30 with resolution of the macular hemorrhage and exudates. Fingolimod has been associated with macular edema, but prior to this report, the authors are unaware of it causing a macular hemorrhage in a MS patient. The authors speculate that the macular hemorrhage may be due to a disruption of cellular adhesions between vascular endothelial cells that maintain the inner blood-retinal barrier.
一位 54 岁女性患有复发性缓解型多发性硬化症（MS），在开始使用芬戈莫德 11 个月后，左眼出现黄斑出血导致视力丧失。左眼视力为 20/80，眼底照相显示黄斑区有浓密的视网膜出血，伴有相邻硬性渗出物和黄斑增厚，频域光学相干断层扫描（SD-OCT）进一步证实了这一点。停用芬戈莫德 3 个月后，左眼视力提高至 20/30，黄斑出血和渗出物吸收。芬戈莫德与黄斑水肿有关，但在本报告之前，作者们不知道它会导致 MS 患者出现黄斑出血。作者推测，黄斑出血可能是由于维持血视网膜内屏障的血管内皮细胞之间细胞黏附的破坏所致。
