Fingolimod treatment in multiple sclerosis leads to increased macular volume

This longitudinal study from America looked at the association of initiation of fingolimod and increased macular volume.

Fingolimod has been associated with the development of cystoid macular odema in a small subset of patients (<1%) but little is known about how the drug generally affects retinal tissue volume in people with MS.

Patients who initiated treatment with fingolimod, received pretreatment and ontreatment spectral-domain optical coherence tomography (SD-OCT). A comparison group of patients with MS never treated with fingolimod were used as the reference cohort. Results showed that the macular volume increased by a mean of 0.025cm3 in the 30 patients with MS who initiated fingolimod over a mean follow-up time of 6 months. 74% of eyes in the fingolimod-treated group exhibited an increase in macular volume compared to 37% of eyes in a comparison group of patients.

These results show a modest, relatively rapid increase in macular volume. The researchers speculate that the observed increase in macular volume most likely reflects a form of tissue swelling as opposed to neuroprotection, but more research is needed to determine the underlying mechanisms.

Authors: Nolan R, Gelfand JM, Green AJ

Source: Neurology. 2012 Dec 5. [Epub ahead of print]

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