The Ocular Manifestations of Drugs Used to Treat Multiple Sclerosis.
Recent times have seen an increase in the number of options to treat multiple sclerosis. Ocular manifestations of multiple sclerosis are well known to treating physicians; however, the medications used to treat multiple sclerosis can also have ocular side effects. This review article focuses on the ocular manifestations of corticosteroids and disease-modifying agents such as interferon, fingolomod, natalizumab, alemtuzumab and mitoxantron used to treat the disease. The ocular manifestations of multiple sclerosis treatments can be varied depending on the drug used, and include retinopathy, chronic central serous chorioretinopathy, macular oedema, Graves' ophthalmopathy and cortical blindness. These effects may be specific to the drug or secondary to their immunosuppressive effect. The association of macular oedema with fingolomod is clear and merits ocular screening for toxicity. The immunosuppressive nature of the treatments makes patients prone to acquired infections. Hence, if a patient with multiple sclerosis presents with vision loss, infectious and drug-induced aetiology should be considered alongside relapses of multiple sclerosis itself as a cause.
York Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, Yo31 8HE, UK.
Gregory
G
Heath
York Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, Yo31 8HE, UK.
Archana
A
Airody
York Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, Yo31 8HE, UK. Richard.gale@york.nhs.uk.
Richard Peter
RP
Gale
D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D005128:Eye Diseases / Q000188:drug therapy*; D000068876:Fingolimod Hydrochloride / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007372:Interferons / Q000627:therapeutic use; D008942:Mitoxantrone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069442:Natalizumab / Q000627:therapeutic use
D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D000074323:Alemtuzumab; D007372:Interferons; D008942:Mitoxantrone; D000068876:Fingolimod Hydrochloride