tacrolimus and Retinal-Diseases

This report highlights the association of tacrolimus use with acute macular neuroretinopathy (AMN). A 27-year-old woman, a known case of diffuse proliferative membranous glomerulonephritis, developed abnormal body movements, loss of consciousness, and blurring of vision in the left eye, after 3 months of starting tacrolimus. Blood investigations revealed anemia, thrombocytopenia, raised urea and creatinine levels, and raised LDH levels. A diagnosis of tacrolimus induced hemolytic uremic syndrome (HUS) with posterior reversible encephalopathy syndrome (PRES) was made. Ocular examination revealed a reddish-brown petaloid retinal lesion, which was better appreciated on red-free imaging as dark grey area pointing towards the fovea. OCT-A and SD-OCT revealed flow voids in deep retinal plexus, and disruption of ellipsoid and interdigitation zone, respectively, findings consistent with AMN. To the best of our knowledge, it is the first report of association of tacrolimus with AMN.

Topics: Adult; Female; Humans; Posterior Leukoencephalopathy Syndrome; Retina; Retinal Diseases; Tacrolimus; Thrombotic Microangiopathies; White Dot Syndromes

Attenuating pathological angiogenesis in diseases characterized by neovascularization such as diabetic retinopathy has transformed standards of care. Yet little is known about the molecular signatures discriminating physiological blood vessels from their diseased counterparts, leading to off-target effects of therapy. We demonstrate that in contrast to healthy blood vessels, pathological vessels engage pathways of cellular senescence. Senescent (p16

Topics: Animals; Apoptosis; bcl-X Protein; Cellular Senescence; Collagen Type I, alpha 1 Chain; Cyclin-Dependent Kinase Inhibitor p16; Disease Models, Animal; Endothelial Cells; Female; Flavonols; Humans; Male; Mice; Mice, Inbred C57BL; Mice, Transgenic; Neovascularization, Pathologic; Retinal Diseases; Tacrolimus

Topics: Adolescent; Blindness; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Peripheral Vascular Diseases; Retinal Diseases; Tacrolimus

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.

Topics: Electroretinography; Evoked Potentials, Visual; Fundus Oculi; Humans; Immunosuppressive Agents; Liver Transplantation; Macula Lutea; Male; Middle Aged; Postoperative Care; Reaction Time; Retinal Diseases; Scotoma; Tacrolimus; Tomography, Optical Coherence

The protein phosphatase 2B inhibitor, FK506, is an immunomodulatory polypeptide that has neuroprotective properties, the mechanisms of which have not been elucidated. A possible mechanism may be phosphorylation-mediated regulation of glutamate transporter activity. In the present study, we investigated the effect of FK506 on glutamate transporter localization and activity in the ischaemic mouse retina. FK506 did not appear to modulate the localization or activity of glutamate transporters under simulated ischaemic conditions. Our present data suggest that the mechanism by which FK506 exerts its neuroprotective action is not attributable to alterations in retinal glutamate transport.

Topics: Amino Acid Transport System X-AG; Animals; Biological Transport; Calcineurin Inhibitors; Female; Glutamic Acid; Immunohistochemistry; Immunosuppressive Agents; Mice; Mice, Inbred C57BL; Reperfusion Injury; Retinal Diseases; Tacrolimus; Tetradecanoylphorbol Acetate

Topics: Adult; Choroid Diseases; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Mycophenolic Acid; Retinal Diseases; Tacrolimus