Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India.
Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India
BMJ Case Rep. 2021 Aug 3;14(8):e243207. doi: 10.1136/bcr-2021-243207.
Fingolimod is a sphingosine-1-phosphate analogue used for the treatment of multiple sclerosis. We, hereby, report a rare case of fingolimod-associated central serous chorioretinopathy (CSCR) in a 21-year-old woman who presented with blurring of vision in the right eye 3 weeks after initiation of oral fingolimod. On examination, best-corrected visual acuity was 20/20 in both the eyes. Fundus examination revealed shallow, serous macular neurosensory detachment in the right eye, and it was confirmed with spectral domain optical coherence tomography. Left eye fundus was normal. Fluorescein angiography showed focal retinal pigment epithelium leak inferior to the fovea. A diagnosis of fingolimod-associated CSCR was made. Oral fingolimod was discontinued. Subsequent follow-up visits showed partial resolution of CSCR at 2 weeks and at 1 month and complete resolution of the subretinal fluid at 2 months. CSCR is, therefore, a rare adverse effect of oral fingolimod treatment. Baseline eye examination and subsequent follow-up at regular intervals are recommended for patients on fingolimod.
芬戈莫德是一种鞘氨醇-1-磷酸类似物,用于治疗多发性硬化症。我们在此报告一例 21 岁女性使用口服芬戈莫德 3 周后出现罕见的芬戈莫德相关性中心性浆液性脉络膜视网膜病变(CSCR)。检查时,双眼最佳矫正视力均为 20/20。右眼眼底检查发现浅层浆液性黄斑神经感觉层脱离,经谱域光相干断层扫描证实。左眼眼底正常。荧光素血管造影显示黄斑下有局灶性视网膜色素上皮渗漏。诊断为芬戈莫德相关性 CSCR。停用口服芬戈莫德。随后的随访显示 2 周、1 个月时 CSCR 部分缓解,2 个月时视网膜下液完全吸收。因此,CSCR 是口服芬戈莫德治疗的罕见不良反应。建议接受芬戈莫德治疗的患者进行基线眼部检查,并定期进行后续随访。