Tacrolimus Optic Neuropathy

J Neuroophthalmol. 2018 Jun;38(2):160-166. doi: 10.1097/WNO.0000000000000635.

Abstract

Background: Tacrolimus (FK506, Prograf) is a potent immunosuppressant, which inhibits cytokine synthesis and blocks T-cell development. Optic neuropathy from tacrolimus toxicity is very uncommon but, when present, can result in severe vision loss.

Methods: Case series and review of the literature.

Results: We present 3 patients with tacrolimus optic neuropathy after bone marrow transplantation complicated by graft-vs-host disease and demonstrate the differing clinical and radiologic presentation of this presumed toxic optic neuropathy.

Conclusions: Tacrolimus optic neuropathy can manifest in a multitude of clinical presentations and can have devastating visual consequences.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Bone Marrow Transplantation / adverse effects
  • Cerebrospinal Fluid
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / etiology
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Leukocytosis
  • Lymphocytes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Optic Disk / pathology
  • Optic Nerve Diseases / chemically induced*
  • Optic Nerve Diseases / diagnosis
  • Tacrolimus / adverse effects*
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology

Substances

  • Immunosuppressive Agents
  • Tacrolimus