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Related Experiment Videos

Blindness after liver transplant.

Daniel G Dawson1, Jonathan D Trobe

  • 1Kellogg Eye Center, Departments of Ophthalmology and Neurology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.

Survey of Ophthalmology
|August 6, 2002
PubMed
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Cyclosporine toxicity can cause reversible vision loss and seizures after liver transplant. Prompt discontinuation of cyclosporine and switching to tacrolimus can restore normal vision and neurological function.

Area of Science:

  • Nephrology
  • Neurology
  • Ophthalmology

Background:

  • Liver transplantation requires immunosuppression to prevent rejection.
  • Cyclosporine is a common immunosuppressant used post-transplant.
  • Posterior reversible encephalopathy syndrome (PRES) is a rare neurological complication.

Observation:

  • A liver transplant recipient presented with seizure and persistent visual disturbances.
  • Brain MRI showed vasogenic edema in the parieto-occipital white matter.
  • Normal cyclosporine levels and mild hypertension were noted.

Findings:

  • The patient experienced visual loss and seizure attributed to cyclosporine toxicity.
  • Discontinuation of cyclosporine and initiation of tacrolimus led to rapid visual recovery.

Related Experiment Videos

  • Follow-up MRI confirmed resolution of white matter abnormalities.

    • Implications:

    • Visual loss can be a primary manifestation of cyclosporine-induced PRES.
    • PRES may occur even with normal cyclosporine levels and mild hypertension.
    • Tacrolimus may serve as a safe alternative immunosuppressant in cases of cyclosporine toxicity.