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Cyclosporin A-induced reversible cortical blindness.
S E Wilson1, P C de Groen, A J Aksamit
1Department of Ophthalmology, Mayo Clinic Foundation, Rochester, Minnesota 55905.
Journal of Clinical Neuro-Ophthalmology
|December 1, 1988
Summary
Cyclosporin A effectively prevents organ transplant rejection but can cause reversible central nervous system toxicity. A liver transplant patient experienced cortical blindness, which resolved after stopping the drug, though some brain damage remained.
Area of Science:
- Immunology
- Neuroscience
- Transplantation Medicine
Background:
- Cyclosporin A is a vital immunosuppressant post-organ transplantation, crucial for preventing allograft rejection.
- Its application has expanded to ophthalmic disease treatment, increasing overall usage.
- Central nervous system (CNS) toxicity is a recognized, yet often reversible, side effect.
Observation:
- A liver transplant recipient presented with profound neurotoxicity, manifesting as cortical blindness.
- This neurological deficit was the primary initial symptom of Cyclosporin A toxicity.
- The patient's neurological symptoms, including blindness, completely resolved upon drug cessation.
Findings:
- Cyclosporin A-induced neurotoxicity can present as cortical blindness.
- Discontinuation of Cyclosporin A led to complete resolution of neurological symptoms.
- Despite clinical recovery, pathological examination revealed persistent central nervous system demyelination 8.5 months post-transplant.
Implications:
- Highlights the importance of monitoring for CNS side effects of Cyclosporin A, even with apparent clinical recovery.
- Suggests that while neurological symptoms may reverse, underlying neuropathological changes like demyelination can persist.
- Underscores the need for further research into the long-term neurological consequences of Cyclosporin A therapy.