Unilateral tacrolimus-associated optic neuropathy after liver transplantation

BACKGROUND: Tacrolimus has been associated with several ocular adverse effects, such as optic neuropathy. METHODOLOGY/PRINCIPAL FINDINGS: A 56-year-old woman noted sudden, severe, painless visual loss in her left eye. She had undergone liver transplantation for alcoholic related cirrhosis 6 months before. Her chronic immunosuppressive regimen consisted of prednisone and tacrolimus at dosage of 1.5 mg orally once daily. Consequently, the patient developed a left optic neuropathy. CONCLUSION/SIGNIFICANCE: We report the first case of unilateral optic neuropathy associated with oral tacrolimus medication. Surgeons and ophthalmologists must evaluate ocular symptoms in the post-transplantation period, and suspicion should be maintained even if unilaterality or asymmetry of symptoms against a toxic etiology.