Cortical blindness secondary to cyclosporine after orthotopic heart transplantation: a case report and review of the literature.
Cyclosporine neurotoxicity has been described after liver, kidney, and bone marrow transplantation and has been associated with a number of risk factors, including hypomagnesemia and low serum cholesterol levels. Reports in heart transplant recipients are less common. We present a patient with cortical blindness secondary to cyclosporine after orthotopic heart transplantation. The patient had confusion, focal visual field defects, and bilateral occipital lobe lesions shown on magnetic resonance imaging. Although he had significant clinical improvement with decreasing cyclosporine levels, residual computerized visual field defects and magnetic resonance imaging abnormalities were documented several months later.
Drachman
B M
BM
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
DeNofrio
D
D
Acker
M A
MA
Galetta
S
S
Loh
E
E
D001766:Blindness / Q000139:chemically induced* / Q000175:diagnosis; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis; D013997:Time Factors; D014793:Visual Cortex / Q000187:drug effects* / Q000473:pathology; D014796:Visual Perception / Q000187:drug effects
D007166:Immunosuppressive Agents; D016572:Cyclosporine