Retinal hemorrhages following fingolimod treatment for multiple sclerosis; a case report.
BACKGROUND
Fingolimod is the first oral agent used for treatment of relapsing-remitting multiple sclerosis. Macular edema, but not retinal hemorrhage, is a well-known adverse effect of fingolimod treatment. To the best of our knowledge, this is the first case report of extensive retinal hemorrhages following fingolimod treatment.


METHODS
A 31-year-old male with relapsing-remitting multiple sclerosis developed macular edema and retinal hemorrhages in his left eye, 1 month after starting fingolimod treatment; treatment was then discontinued. The hemorrhages were flame-shaped, and were extensive along retinal arteries and veins. The hemorrhages started to decrease at 4 weeks and disappeared completely at 24 weeks after cessation of fingolimod treatment.


CONCLUSIONS
Occurrence of retinal hemorrhage warrants careful follow-up for multiple sclerosis patients treated with fingolimod.
Department of Ophthalmology, Kyoto Hakuaikai Hospital, 1 Keshiyama, Kamigamo, Kita-ku, Kyoto, 603-8041, Japan. naonao33k6ki@hotmail.co.jp.
Naoko
N
Ueda
Department of Neurology, Kyoto Hakuaikai Hospital, 1 Keshiyama, Kamigamo, Kita-ku, Kyoto, 603-8041, Japan. saidakyoko@yahoo.co.jp.
Kyoko
K
Saida
D000328:Adult; D000068876:Fingolimod Hydrochloride / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008269:Macular Edema / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D041623:Tomography, Optical Coherence
D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride