Fukuoka Hideki, Kojima Kentaro, Iwama Ayako, Okumura Takahiro, Sotozono Chie
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Am J Ophthalmol Case Rep. 2022 Apr 22;26:101553. doi: 10.1016/j.ajoc.2022.101553. eCollection 2022 Jun.
To report a rare case in which a patient undergoing long-term oral fingolimod treatment for multiple sclerosis (MS) developed late-onset severe bilateral cystoid macular edema (ME) at 3-weeks post cataract surgery.
This study involved a 61-year-old female undergoing long-term oral fingolimod treatment for MS in whom at 4-years post initiation of treatment and the treatment being tapered to a 0.5 mg twice-weekly dose severe bilateral cystoid ME occurred at 3-weeks post cataract surgery. Although the patient was administered the proper treatments for pseudophakic ME, including a 20-mg sub-Tenon's-capsule triamcinolone acetonide injection, it took 13 months for the ME to ultimately resolve with continued oral fingolimod treatment.
The findings in this study show that severe bilateral cystoid ME can occur even several years after initiating fingolimod treatment, thus indicating that detailed follow-up is necessary post cataract surgery.
报告1例罕见病例，1例长期口服芬戈莫德治疗多发性硬化症（MS）的患者在白内障手术后3周出现迟发性严重双侧黄斑囊样水肿（ME）。
本研究纳入1例61岁女性，该患者因MS接受长期口服芬戈莫德治疗，治疗开始4年后，治疗剂量减至每周两次、每次0.5mg时，在白内障手术后3周出现严重双侧囊样ME。尽管患者接受了针对人工晶状体性ME的适当治疗，包括20mg曲安奈德Tenon囊下注射，但在继续口服芬戈莫德治疗的情况下，ME最终消退仍花费了13个月。
本研究结果表明，即使在开始使用芬戈莫德治疗数年之后，仍可能发生严重双侧囊样ME，这表明白内障手术后需要进行详细的随访。
