Tacrolimus associated Ischemic Optic Neuropathy

Tacrolimus is widely used immunosuppressant and though neurotoxicity is well recognized as a side effect, the risk of toxic optic neuropathy is low and described in a few case reports. Tacrolimus related optic nerve toxicity has been reported to present as bilateral1-2,6, asymmetric bilateral3 and even unilateral4-6 optic neuropathy mimicking ischemic or demyelinating optic neuropathy. We report here two patients presenting as unilateral, ischemic optic neuropathy while on tacrolimus therapy.