Longitudinal quantitative assessment of macula during therapy with fingolimod in relapsing-remitting multiple sclerosis

Int Ophthalmol. 2019 Apr;39(4):777-781. doi: 10.1007/s10792-018-0870-x. Epub 2018 Mar 2.

Abstract

Purpose: Fingolimod is the first oral drug approved for treatment of relapsing-remitting multiple sclerosis (RR-MS), and it has potential macular side effects. Despite the qualitative evidence of macular oedema under treatment, longitudinal quantitative assessment is lacking. To address this issue, we measured macular volume and central foveal thickness in a cohort of MS patients on fingolimod over 12 months of treatment.

Methods: Central foveal thickness (CFT) and total macular volume (TMV) were longitudinally recorded with spectral-domain optical coherence tomography in a cohort of 23 RR-MS patients treated with fingolimod at baseline, 3, 6 and 12 months. OCT parameters were analysed considering previous history of optic neuritis (ON). Comparison of means was performed with variance analysis (ANOVA).

Results: Macular oedema occurred in none of the patients. Comparing both groups of patients (with and without previous ON), no statistically significant difference was found during the follow-up both for CFT and TMV (p = 0.99 and p = 0.96, respectively) although a slight early but not significant TMV reduction was detected.

Conclusions: In our cohort, therapy with fingolimod did not cause any change in CFT and TMV in MS patients during a 12-month follow-up independent of previous ON.

Keywords: Central foveal thickness; Fingolimod; Multiple sclerosis; Optic neuritis; Spectral-domain optical coherence tomography; Total macular volume.

MeSH terms

  • Adult
  • Analysis of Variance
  • Female
  • Fingolimod Hydrochloride / adverse effects*
  • Fingolimod Hydrochloride / therapeutic use
  • Fovea Centralis / pathology
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Macula Lutea / pathology*
  • Macular Edema / chemically induced*
  • Macular Edema / pathology
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Tomography, Optical Coherence

Substances

  • Immunosuppressive Agents
  • Fingolimod Hydrochloride