芬戈莫德与黄斑水肿：病理生理学、诊断及管理
Fingolimod and macular edema: Pathophysiology, diagnosis, and management.
作者信息
Cugati Sudha, Chen Celia S, Lake Stewart, Lee Andrew W
机构信息
Department of Ophthalmology (SC, CSC, SL), Flinders Medical Centre and Flinders University; and Flinders Comprehensive Stroke Centre (AWL), Flinders Medical Centre, Bedford Park, Australia.
出版信息
Neurol Clin Pract. 2014 Oct;4(5):402-409. doi: 10.1212/CPJ.0000000000000027.
Abstract
Fingolimod causes macular edema (ME) by acting via the S1P3 receptor agonism, thereby reducing the tight junction between the endothelial cells of the retinal capillaries. This results in the breakdown of the inner blood retinal barrier, causing ME. Ophthalmologic evaluation including optical coherence tomography is recommended at baseline and then at 3 months, 6 months, and annually thereafter in all patients on fingolimod. The risk of ME increases in patients who are diabetic, have had uveitis, or who undergo intraocular procedures such as cataract surgery, and hence these patients need close monitoring. Cessation of the drug results in resolution of the ME. However, ME can also be treated using anti-inflammatory medication (steroids) in patients who opt to remain on fingolimod.
摘要
芬戈莫德通过作用于S1P3受体激动剂导致黄斑水肿（ME），从而减少视网膜毛细血管内皮细胞之间的紧密连接。这导致视网膜内血液屏障的破坏，引发ME。建议对所有服用芬戈莫德的患者在基线时进行眼科评估，包括光学相干断层扫描，然后在3个月、6个月时进行评估，此后每年评估一次。糖尿病患者、患有葡萄膜炎的患者或接受白内障手术等眼内手术的患者发生ME的风险增加，因此这些患者需要密切监测。停药可使ME消退。然而，对于选择继续服用芬戈莫德的患者，也可以使用抗炎药物（类固醇）治疗ME。
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