Evaluation of the effect of fingolimod (FTY720) on macular perfusion by swept-source optical coherence tomography angiography in patients with multiple sclerosis

AIM: To determine changes in retinal microcirculation, caused by fingolimod (FTY720) use, via swept‐source optical coherence tomography angiography (SS‐OCTA) in relapsing‐remitting multiple sclerosis (RR‐MS) patients. MATERIALS AND METHODS: 80 patients with RR‐MS, who were using fingolimod, and 50 healthy control subjects were included in the study. Group 1 consisted of 40 eyes from 40 RR‐MS patients, who had been using fingolimod for less than six months, and Group 2 consisted of 40 eyes from 40 RR‐MS patients, who had been using fingolimod for longer than six months. All participants underwent SS‐OCTA via DRI OCT Triton (Topcon, Tokyo, Japan), analysing their central macular thickness (CMT) (µm), subfoveal choroidal thickness (SFCT) (µm), superficial (VDs) (%) and deep vascular plexuses (VDd) (%), choriocapillaris (VDcc) (%), and superficial and deep foveal avascular zones (FAZs, FAZd, respectively) (%) in mean values. RESULTS: The mean follow‐up times for patients in Groups 1 and 2 were 2.9 ± 1.5 months and 22.5 ± 11.3 months, respectively. The FAZs value in Group 2 was found to be significantly higher than that in both Group 1 and the control group (p = 0.034, p = 0.042, respectively). The VDs central value in Group 2 did not differ significantly from that in Group 1 or the control group (p > 0.05), while the VDs central value was higher in Group 1 than in the control group (p = 0.008). In Group 1, the VDd central value was significantly higher than in Group 2 and the control group (p = 0.047; p = 0.020, respectively). The CMT measurement for Group 2 was significantly lower than in Group 1 and the control group (p = 0.008, p = 0.003, respectively). CONCLUSION: Fingolimod use seems to remarkably increase VDs and VDd measurements in the early period of administration and decrease CMT over a longer period of administration in patients with RR‐MS.