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[Cortical blindness during treatment with cyclosporin]
L T Vlasveld1, J J Cornelissen, P L Dellemijn
1Afd. Hematologie, Dr. Daniel den Hoed Kliniek, Rotterdam.
Nederlands Tijdschrift Voor Geneeskunde
|October 8, 1994
Summary
Cyclosporin treatment can cause cortical blindness, particularly in patients with low magnesium levels. Vision recovery occurred after stopping cyclosporin and correcting hypomagnesaemia.
Area of Science:
- Nephrology
- Hematology
- Ophthalmology
Background:
- Cyclosporin (cyclosporine) is an immunosuppressant commonly used after organ and bone marrow transplantation.
- Chronic myeloid leukemia (CML) is a type of cancer affecting white blood cells.
- Allogeneic bone marrow transplantation is a procedure to replace damaged bone marrow.
Observation:
- A 40-year-old male patient developed sudden cortical blindness post-allogeneic bone marrow transplant for CML.
- The patient exhibited therapeutic cyclosporin blood levels but had concurrent hypomagnesaemia and hypertension.
- Symptoms included headache and paraesthesia, alongside visual disturbances.
Findings:
- Cortical blindness resolved completely after discontinuing cyclosporin and correcting low serum magnesium levels.
- This case adds to the 18 reported instances of cyclosporin-induced cortical blindness.
- Hypomagnesaemia is strongly suggested as a contributing factor in the development of this adverse effect.
Implications:
- Clinicians should monitor magnesium levels in patients receiving cyclosporin, especially those with neurological symptoms.
- Early recognition and management of hypomagnesaemia may prevent or reverse cyclosporin-associated visual disturbances.
- This highlights the importance of metabolic monitoring in immunosuppressed patients to mitigate severe side effects.