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Sirolimus Induced Toxic Optic Neuropathy.

Parastou Pakravan¹, Shahnaz Miri¹, Byron L Lam¹

¹Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

International Medical Case Reports Journal

|June 7, 2023

Summary

This summary is machine-generated.

This case report details optic neuropathy in a cardiac transplant patient after long-term sirolimus use. Vision improved after switching to cyclosporin, suggesting sirolimus as a potential cause.

Keywords:

immunosuppressant optic neuropathy sirolimus vision loss

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Area of Science:

Ophthalmology
Transplant Surgery
Pharmacology

Background:

Sirolimus, an mTOR inhibitor, is used for immunosuppression post-transplant.
Optic neuropathy is a rare side effect associated with immunosuppressants like tacrolimus.
This is the first reported case of optic neuropathy linked to prolonged sirolimus therapy.

Observation:

A 69-year-old male cardiac transplant recipient experienced progressive, painless vision loss.
Ophthalmic examination revealed reduced visual acuity, impaired color vision, bilateral disc pallor, and visual field constriction.
Orbital MRI showed chiasmatic changes; other causes were excluded.

Findings:

The patient had received sirolimus for over 7 years.
Sirolimus was switched to cyclosporin, resulting in gradual visual and visual field improvement.
This suggests sirolimus-induced optic neuropathy.

Implications:

Prolonged sirolimus therapy may lead to optic neuropathy.
Monitoring visual function is crucial in transplant patients on sirolimus.
Switching immunosuppressive agents can reverse sirolimus-related visual deficits.