Siponimod-associated cystoid macular edema without known risk factors
Purpose: This case report highlights the importance of monitoring ocular health for patients starting on siponimod treatment, a sphingosine-1-phosphate receptor modulator, for relapsing-remitting multiple sclerosis. By showing how medication adverse events present in patients, we can revisit the cur...
        Saved in:
      
    
          | Main Authors: | , , , | 
|---|---|
| Format: | Article | 
| Language: | English | 
| Published: | 
            Elsevier
    
        2024-12-01
     | 
| Series: | American Journal of Ophthalmology Case Reports | 
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001348 | 
| Tags: | 
       Add Tag    
     
      No Tags, Be the first to tag this record!
   
 | 
| _version_ | 1846117792304070656 | 
    
|---|---|
| author | Min Young Kim Anas Alkhabaz, MBBS Stephen J. Smith, M.D. Yaping Joyce Liao, M.D., Ph.D.  | 
    
| author_facet | Min Young Kim Anas Alkhabaz, MBBS Stephen J. Smith, M.D. Yaping Joyce Liao, M.D., Ph.D.  | 
    
| author_sort | Min Young Kim | 
    
| collection | DOAJ | 
    
| description | Purpose: This case report highlights the importance of monitoring ocular health for patients starting on siponimod treatment, a sphingosine-1-phosphate receptor modulator, for relapsing-remitting multiple sclerosis. By showing how medication adverse events present in patients, we can revisit the current guidelines on ophthalmic evaluation recommendations. Observations: We report a 60-year-old patient who presented with unilateral blurry vision upon initiating siponimod therapy for the treatment of relapsing-remitting multiple sclerosis. Her exam findings did not show visual field defects but were significant for cystoid macular edema distorting the foveal contour. Upon stopping siponimod therapy, the patient's macular edema and symptoms resolved significantly within 7 days and completely resolved 1 month later. Conclusions and importance: This case showcases siponimod-associated cystoid macular edema in a patient without known risk factors, such as diabetes mellitus and uveitis. The patient also had the earliest reported symptom onset to date following the initiation of siponimod therapy. Current recommendations from the American Academy of Ophthalmology and FDA stress the importance of ophthalmic evaluation three to four months after treatment initiation for patients with a history of risk factors. Given our current case and its comparison with four previously reported cases, we recommend that physicians inform patients of possible ocular adverse events with siponimod therapy regardless of their past medical history and duration of treatment. | 
    
| format | Article | 
    
| id | doaj-art-44623265d4ff4607a9b0be615476646a | 
    
| institution | Kabale University | 
    
| issn | 2451-9936 | 
    
| language | English | 
    
| publishDate | 2024-12-01 | 
    
| publisher | Elsevier | 
    
| record_format | Article | 
    
| series | American Journal of Ophthalmology Case Reports | 
    
| spelling | doaj-art-44623265d4ff4607a9b0be615476646a2024-12-18T08:50:29ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102124Siponimod-associated cystoid macular edema without known risk factorsMin Young Kim0Anas Alkhabaz, MBBS1Stephen J. Smith, M.D.2Yaping Joyce Liao, M.D., Ph.D.3Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA; Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USAByers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USAByers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USAByers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA; Corresponding author. Byers Eye Institute, Department of Ophthalmology, Stanford University, School of Medicine, 2452 Watson Court, Palo Alto, CA, 94303-5252, USAPurpose: This case report highlights the importance of monitoring ocular health for patients starting on siponimod treatment, a sphingosine-1-phosphate receptor modulator, for relapsing-remitting multiple sclerosis. By showing how medication adverse events present in patients, we can revisit the current guidelines on ophthalmic evaluation recommendations. Observations: We report a 60-year-old patient who presented with unilateral blurry vision upon initiating siponimod therapy for the treatment of relapsing-remitting multiple sclerosis. Her exam findings did not show visual field defects but were significant for cystoid macular edema distorting the foveal contour. Upon stopping siponimod therapy, the patient's macular edema and symptoms resolved significantly within 7 days and completely resolved 1 month later. Conclusions and importance: This case showcases siponimod-associated cystoid macular edema in a patient without known risk factors, such as diabetes mellitus and uveitis. The patient also had the earliest reported symptom onset to date following the initiation of siponimod therapy. Current recommendations from the American Academy of Ophthalmology and FDA stress the importance of ophthalmic evaluation three to four months after treatment initiation for patients with a history of risk factors. Given our current case and its comparison with four previously reported cases, we recommend that physicians inform patients of possible ocular adverse events with siponimod therapy regardless of their past medical history and duration of treatment.http://www.sciencedirect.com/science/article/pii/S2451993624001348Cystoid macular edemaSiponimodCMEFingolimodAdverse eventS1P | 
    
| spellingShingle | Min Young Kim Anas Alkhabaz, MBBS Stephen J. Smith, M.D. Yaping Joyce Liao, M.D., Ph.D. Siponimod-associated cystoid macular edema without known risk factors American Journal of Ophthalmology Case Reports Cystoid macular edema Siponimod CME Fingolimod Adverse event S1P  | 
    
| title | Siponimod-associated cystoid macular edema without known risk factors | 
    
| title_full | Siponimod-associated cystoid macular edema without known risk factors | 
    
| title_fullStr | Siponimod-associated cystoid macular edema without known risk factors | 
    
| title_full_unstemmed | Siponimod-associated cystoid macular edema without known risk factors | 
    
| title_short | Siponimod-associated cystoid macular edema without known risk factors | 
    
| title_sort | siponimod associated cystoid macular edema without known risk factors | 
    
| topic | Cystoid macular edema Siponimod CME Fingolimod Adverse event S1P  | 
    
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001348 | 
    
| work_keys_str_mv | AT minyoungkim siponimodassociatedcystoidmacularedemawithoutknownriskfactors AT anasalkhabazmbbs siponimodassociatedcystoidmacularedemawithoutknownriskfactors AT stephenjsmithmd siponimodassociatedcystoidmacularedemawithoutknownriskfactors AT yapingjoyceliaomdphd siponimodassociatedcystoidmacularedemawithoutknownriskfactors  |