BMJ Case Reports 2017; doi:10.1136/bcr-2016-218912
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Fingolimod-associated macular oedema

  1. Tariq Aslam3
  1. 1Department of Vitreoretina, Manchester Royal Eye Hospital, Manchester, Lancashire, UK
  2. 2Neurology, Salford Royal NHS Foundation Trust, Manchester, Lancashire, UK
  3. 3Medical Retina, Manchester Royal Eye Hospital, Manchester, Lancashire, UK
  4. 4Neurology, Salford Royal NHS Foundation Trust, Manchester, Lancashire, UK
  1. Correspondence to Mr Kirti Madhukar Jasani, kirtijasani{at}
  • Accepted 2 April 2017
  • Published 15 June 2017


A 54-year-old female with history of relapsing remitting multiple sclerosis (MS) was switched from interferon beta-1A (Avonex, Biogen) to fingolimod (Gilenya, Novartis) therapy after having two clinical relapses within 2 years while on treatment. As part of her treatment protocol, she was referred to the local ophthalmology unit for a baseline screen and periodic review thereafter. Three months into her treatment, she complained of blurring of vision in her right eyeA visual acuity assessment showed a reduction in best-corrected visual acuity (BCVA) from 6/6 to 6/12. An optical coherence tomography (OCT) scan showed evidence of oedema and cystic changes within her right macula (figure 1). She was diagnosed with fingolimod-associated macular oedema (FAME) and was started on topical steroids (prednisolone acetate 1% four times a day) and non-steroidal treatment to her right eye. The patient …

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