Mack Heather Gwen, Tien Melissa Chih-Hui, White Owen Bruce
Cabrini Medical Centre, Malvern, VIC, Australia; Melbourne Health, Parkville, VIC, Australia; Department of Surgery, University of Melbourne, Parkville, VIC, Australia; Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Case Rep Ophthalmol. 2016 Dec 8;7(3):284-288. doi: 10.1159/000453392. eCollection 2016 Sep-Dec.
Fingolimod is an oral sphingosine-1-phosphate (S1P) receptor modulator and the first oral therapy for relapsing-remitting multiple sclerosis. Its use has been complicated by a low rate of cystoid macular edema usually in the first 3 months after commencement of the medication. We report the case of a 34-year-old male with relapsing-remitting multiple sclerosis, who developed acute anterior uveitis on day 5 of fingolimod treatment. He responded to appropriate treatment and cessation of drug, but developed low-grade chronic anterior uveitis without cystoid macular edema. We discuss possible mechanisms of uveitis onset in this group of patients. Urgent ophthalmological review is recommended for patients receiving fingolimod therapy who develop a red, painful eye, which may occur within 5 days of fingolimod treatment initiation.
芬戈莫德是一种口服鞘氨醇-1-磷酸(S1P)受体调节剂,是复发缓解型多发性硬化症的首个口服治疗药物。其使用情况因通常在用药开始后的前3个月出现的低发生率的黄斑囊样水肿而变得复杂。我们报告了一例34岁复发缓解型多发性硬化症男性患者,在芬戈莫德治疗第5天发生急性前葡萄膜炎。他对适当治疗和停药有反应,但出现了无黄斑囊样水肿的轻度慢性前葡萄膜炎。我们讨论了该组患者葡萄膜炎发病的可能机制。对于接受芬戈莫德治疗且出现眼红、眼痛的患者,建议紧急进行眼科检查,这种情况可能在芬戈莫德治疗开始后的5天内发生。