Bilateral optic neuropathy after bone marrow transplantation and cyclosporin A therapy.

BACKGROUND: Cyclosporin A (CsA) is widely used as a prophylactic and therapeutic agent against graft-versus-host disease after bone marrow transplantation. Under this condition optic neuropathy has been found and considered as a possible side effect of cyclosporin A. CASE REPORT: A 52-year-old man presented with bilateral optic disc swelling and visual loss 6 months after bone marrow transplantation. Cyclosporin A was the only medication with a known neurotoxic side effect. After cessation of cyclosporin A and treatment with oral prednisone, vision improved within 2 months. Optic disc swelling ameliorated within 6 months but partial optic atrophy developed. DISCUSSION: Cyclosporin A given after bone marrow transplantation may have caused bilateral optic neuropathy in our patient. Microangiopathy of the optic nerve may be the pathogenetic mechanism.