PROGRESSIVE VISUAL DETERIORATION LEADING TO BLINDNESS AFTER PEDIATRICHEART-TRANSPLANTATION

We present the case of a 10-year-old girl who developed visual loss pr ogressing to blindness after orthotopic heart transplantation and an i mmunosuppressive regimen of cyclosporine, azathioprine, and prednisone . Headaches and visual deterioration began 2 months after transplantat ion, and a diagnosis of pseudotumor cerebri was made. The patient's vi sual loss continued despite aggressive medical and surgical therapy, w hich included bilateral optic nerve sheath fenestration. To our knowle dge, permanent visual loss as a late sequela following pediatric heart transplantation and immunosuppressive therapy has not been reported p reviously in the English literature. Although the cause of visual loss after transplantation in our patient is poorly understood, we conclud e that permanent visual loss, although rare, should be considered as a possible late neurologic sequela after pediatric heart transplantatio n.