Advertisement

International Ophthalmology

, Volume 39, Issue 4, pp 777–781 | Cite as

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

  • Mario FruschelliEmail author
  • Marco Capozzoli
  • Maria Chiara Gelmi
  • Gianni Masi
  • Pasquale Annunziata
Original Paper
  • 172 Downloads

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

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

Notes

Compliance with ethical standards

Conflict of interest

This is an independent work not supported by any sponsor. The authors have no financial interest regarding the content of this paper.

References

  1. 1.
    Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG (2000) Multiple sclerosis. N Engl J Med 343:938–952.  https://doi.org/10.1056/NEJM200009283431307 CrossRefGoogle Scholar
  2. 2.
    Kappos L, Radue EW, O’Connor P, Polman C, Hohlfeld R, Calabresi P, Selmaj K, Agoropoulou C, Leyk M, Zhang-Auberson L, Burtin P for the FREEDOMS Study Group (2010) A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. New Engl J Med 362:387–401.  https://doi.org/10.1056/NEJMoa0909494 CrossRefGoogle Scholar
  3. 3.
    Cohen JA, Barkhof F, Comi G, Hartung HP, Khatri BO, Montalban X, Pelletier J, Capra R, Gallo P, Izquierdo G, Tiel-Wilck K, de Vera A, Jin J, Stites T, Wu S, Aradhye S, Kappos L, for the TRANSFORMS Study Group (2010) Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. New Engl J Med 362:402–415.  https://doi.org/10.1056/nejmoa0907839 CrossRefGoogle Scholar
  4. 4.
    Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability scale (EDSS). Neurology 33:1444–1452CrossRefGoogle Scholar
  5. 5.
    Cennamo G, Romano MR, Vecchio EC, Minervino C, Della Guardia C, Velotti N, Carotenuto A, Montella S, Orefice G, Cennamo G (2016) Anatomical and functional retinal changes in multiple sclerosis. Eye (Lond) 30:456–462.  https://doi.org/10.1038/eye.2015.256 CrossRefGoogle Scholar
  6. 6.
    Nolan R, Gelfand JM, Green AJ (2013) Fingolimod treatment in multiple sclerosis leads to increased macular volume. Neurology 80:139–144.  https://doi.org/10.1212/WNL.0b013e31827b9132 CrossRefGoogle Scholar
  7. 7.
    Zarbin MA, Jampol LM, Jager RD, Reder AT, Francis G, Collins W, Tang D, Zhang X (2013) Ophthalmic evaluations in clinical studies of fingolimod (FTY720) in multiple sclerosis. Ophthalmology 120:1432–1439.  https://doi.org/10.1016/j.ophtha.2012.12.040 CrossRefGoogle Scholar
  8. 8.
    Costello F (2017) Optical coherence tomography in neuro-ophthalmology. Neurol Clin 35:153–163.  https://doi.org/10.1016/j.ncl.2016.08.012 CrossRefGoogle Scholar
  9. 9.
    Jain N, Bhatti MT (2012) Fingolimod-associated macular edema: incidence, detection, and management. Neurology 78:672–680.  https://doi.org/10.1212/WNL.0b013e318248deea CrossRefGoogle Scholar
  10. 10.
    Soliman MK, Sarwar S, Sadiq MA, Jack L, Jouvenat N, Zabad RK, Kedar S, Nguyen QD (2016) Acute onset of fingolimod-associated macular edema. Am J Ophthalmol Case Rep 4:67–70CrossRefGoogle Scholar
  11. 11.
    Winges KM, Werner JS, Harvey DJ, Cello KE, Durbin MK, Balcer LJ, Calabresi PA, Keltner JL (2013) Baseline retinal nerve fiber layer thickness and macular volume quantified by OCT in the North American phase 3 fingolimod trial for relapsing-remitting multiple sclerosis. J Neuroophthalmol 33:322–329.  https://doi.org/10.1097/WNO.0b013e31829c51f7 CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Ophthalmology Unit, Department of Medicine, Surgery and NeurosciencesUniversity of SienaSienaItaly
  2. 2.Graduate School of Ophthalmology, Department of Medicine, Surgery and NeurosciencesUniversity of SienaSienaItaly
  3. 3.Clinical Neuroimmunology Unit, Department of Medicine, Surgery and NeurosciencesUniversity of SienaSienaItaly
  4. 4.Dipartimento di Scienze Mediche, Chirurgiche e NeuroscienzeUniversità di SienaSienaItaly

Personalised recommendations