Premium
Unilateral ischemic optic neuropathy by tacrolimus after liver transplantation
Author(s) -
RAMIRO P,
MATEO J,
CABEZON L,
IBANEZ J,
PEIRO C,
JIMENEZ B,
PADGETT E,
CRISTOBAL JA
Publication year - 2011
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.327.x
Subject(s) - medicine , tacrolimus , optic neuropathy , transplantation , ischemic optic neuropathy , liver transplantation , ophthalmology , surgery , optic nerve
Purpose To report a case of unilateral optic neuropathy in a patient on treatment with tacrolimus (Prograf®) after liver transplantation. Methods Case report in a 53‐years old woman receiving tacrolimus after liver transplantation, serial neuroophtalmologic exams were performed. Results 53 years‐ old woman treated with tacrolimus (Progra®f) after liver transplantation, seen in our clinic concerned by the loss of vision in left eye after several previous chapters of amurosis fugax.She was made a carotid doppler (unaltered) and vertebrobasilar (also normal).We ask that RMN detected mild variable Dandy‐Walker, subcortical atrophy, sylvian gaps in deep white matter of probable vascular origin (would microbleeds) and possible osmotic myelinolysis. PCR was elevated and VSG, consistent with pathology data accompanying the patient. Blood analysis showed alterations also be explained by what was happening.Vitamin B12 and folic acid were normal.Serologic tests for Brucella, Borrelia, syphilis, Epstein‐Barr virus, cytomegalovirus, herpes simplex and zoster were negative.Normal coagulation. Following these studies was diagnosed by non‐arteritic NOIA and tacrolimus treatment was added to adiro® 100 mg.The vision was 20/20 in right eye and amaurosis (no light perception) in OI. Had a pupillary afferent deffect in left eye. PIO of 15 mmHg in both eyes. Camera anterior large and transparent crystal. Fundus slight optic nerve pallor in the left eye.OCT with great thinning of the RNFL in the left eye and normal right eye Conclusion Tacrolimus is an immunosuppressive agent useful in hepatic transplantation which may be associated with ischemic optic atrophy.