Tacrolimus-induced optic neuropathy ¬– a case report

Lepša Žorić; Aleksandra Ilić; Emina Čolak; Miloš Mirković; Jelica Pantelić; Dijana Mirić; Bojana Kisić

doi:10.2298/VSP201126004Z

Lepša Žorić University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia
Aleksandra Ilić University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia
Emina Čolak University Clinical Center of Serbia, Institute of Medical Biochemistry, Belgrade, Serbia
Miloš Mirković University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia
Jelica Pantelić University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia
Dijana Mirić University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia
Bojana Kisić University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia

DOI: https://doi.org/10.2298/VSP201126004Z

Keywords: drug-related side effects and adverse reactions, tacrolimus, toxic optic neuropathy, treatment outcome

Abstract

Introduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in the prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosuppressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old male patient, who had received tacrolimus therapy for nine years after kidney transplantation, developed a subacute, painless vision loss in both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. The patient’s therapy was converted to cyclosporine by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on the nervous system, optic neuropathy can cause great and permanent functional impairment.

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