Vojnosanitetski pregled 2022 Volume 79, Issue 6, Pages: 619-623
https://doi.org/10.2298/VSP201126004Z
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Tacrolimus-induced optic neuropathy: A case report
Žorić Lepša (University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia + University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia), zoriclepsa@gmail.com
Ilić Aleksandra (University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Čolak Emina (University Clinical Center of Serbia, Institute of Medical Biochemistry, Belgrade, Serbia)
Mirković Miloš (University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia)
Pantelić Jelica 
(University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Mirić Dijana (University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia)
Kisić Bojana (University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia)
Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive
drug with growing usage. It is usually used in prevention of transplanted
organ rejection. Its use is highly valuable, but like other
immunosupressants, it has adverse effects. One of them is optic neuropathy.
Case report. A 47-year-old white male patients who had received tacrolimus
therapy for nine years, after kidney transplantation, developed a subacute,
painless vision loss on 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. His 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 nervous
system, optic neuropathy can causes great and permanent functional
impairment.
Keywords: drug-related side effects and adverse reactions, tacrolimus, toxic optic neuropathy, treatment outcome
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