Walsh & Hoyt: Neuro-Ophthalmologic Complications

Numerous visual symptoms may occur in patients on cyclosporine, including visual hallucinations, visual field defects, visual agnosia, Balints syndrome, cortical blindness, Antons syndrome, and optic neuropathy. In a series of 582 patients undergoing allogeneic BMT, 4 patients developed transient unilateral or bilateral VIth nerve palsies which were ascribed to cyclosporine toxicity, although the possibility of myasthenia gravis was also discussed. Ophthalmoplegia has been described in BMT patients with features similar to Wernickes encephalopathy, which is believed to be secondary to thiamine deficiency. Ocular flutter has been attributed to cyclosporine toxicity in patients undergoing BMT. Internuclear ophthalmoplegia and nystagmus were noted in a patient who had previously undergone BMT and was being treated with FK 506. Enhancement within the brainstem spontaneously resolved after discontinuing the immunosuppressive therapy. No abnormalities were noted within the cerebral cortex. Cerebral blindness