Siponimod-related bilateral cystoid macular oedema and intravenous fluorescein angiographic findings in a patient with stable proliferative diabetic retinopathy without history of diabetic macular oedema. Issue 11 (11th November 2022)

• Record Type: Journal Article
• Authors: Foos, William F; Culp, Catherine; Asahi, Masumi; Patronas, Marena
• Is Part Of: BMJ case reports. Volume 15:Issue 11(2022)
• Publication Date: 2022-11-11
• Subjects: Drugs: CNS (not psychiatric) -- Retina -- Macula -- Unwanted effects / adverse reactions -- Multiple sclerosis; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2022-251066
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Siponimod is a sphingosine-1-phosphate receptor modulator used as disease-modifying therapy for relapsing-remitting multiple sclerosis similar to Fingolimod which has been known to cause dose dependent fingolimod associated macular oedema (FAME). We report a case of delayed onset bilateral cystoid macular oedema in a patient with stable proliferative diabetic retinopathy who developed cystoid macular oedema in the setting of siponimod (Mayzent; Novartis Pharmaceuticals; Cambridge, Massachusetts, USA) use. As with FAME, cystoid macular oedema resolved in the patient's eyes with drug cessation and adjunctive topical anti-inflammatory therapy. We highlight unique fluorescein angiographic findings within this class of drugs as well as the clinical challenge posed by comorbid diabetic and inflammatory ophthalmic pathology.