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Bilateral fingolimod-associated macular oedema development after cataract surgery
  1. Matthew Gillam1,2 and
  2. Theresa Richardson1
  1. 1Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK
  2. 2Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Ms Theresa Richardson; theresa.richardson1{at}nhs.net

Abstract

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.

  • multiple sclerosis
  • retina
  • contraindications and precautions
  • eye

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Footnotes

  • Contributors TR was the patient’s treating clinician. MG undertook the literature search and wrote the case report. TR reviewed the final manuscript before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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