Korean J Ophthalmol.  2011 Feb;25(1):69-71. 10.3341/kjo.2011.25.1.69.

Maculopathy Associated with Tacrolimus (FK 506)

• Koh T
• Baek SH
• Han JI
• Kim US

• KMID: 994418
• DOI: http://doi.org/10.3341/kjo.2011.25.1.69

Abstract

A 63-year-old man with a history of liver transplantation presented to our clinic complaining of visual disturbance. He had been receiving tacrolimus (FK 506) for 30 months (6 mg/day for 2 years and 3 mg/day for 6 months); he reported that the visual disturbance began while taking tacrolimus. A full ophthalmologic examination and electrophysiologic and imaging studies were performed. The best corrected visual acuity was 0.1 in both eyes. There were no abnormal finding in the anterior segment, pupillary reflexes were normal and, there was no swelling in either optic disc. Although the foveal reflex was slightly decreased, fluorescein angiography revealed non-specific signs, with the exception of a window defect. A multifocal electro-retinogram revealed decreased amplitude of the central ring. A Swedish interactive threshold algorithm-standard 10-2 visual field test revealed a central scotoma. These findings suggest that tacrolimus may result in maculopathy. Therefore, careful ophthalmologic examination is necessary in the patients taking tacrolimus.

Keyword

Maculopathy; Optic neuropathy; Tacrolimus; Transplantation; Visual field

MeSH Terms

Electroretinography
Evoked Potentials, Visual
Fundus Oculi
Humans
Immunosuppressive Agents/*adverse effects/therapeutic use
Liver Transplantation
Macula Lutea/*drug effects
Male
Middle Aged
Postoperative Care
Reaction Time
Retinal Diseases/*chemically induced/diagnosis
Scotoma/chemically induced/diagnosis
Tacrolimus/*adverse effects/therapeutic use
Tomography, Optical Coherence

Figure

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  Fig. 1 Fundus photography and fluorescein angiography revealed non-specific findings in both eyes.

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  Fig. 2 Optical coherence tomography of the macular area revealed no definite abnormal findings.

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  Fig. 3 The multifocal electroretinogram demonstrated foveal suppression in both eyes (A,B). A central scotoma was noted on central 10-2 threshold visual field testing (C,D). MD=mean deviation; PSD=pattern standard deviation.

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  Fig. 4 Visual evoked potential (VEP) revealed P100 delay in both eyes.

Reference

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