Tacrolimus Optic Neuropathy Mimicking Papilledema
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Bibliographic record
Abstract
Tacrolimus (FK506) is a potent and effective immunosuppressive agent, mainly utilized after solid organ transplantation. We report the clinical features of tacrolimus optic neuropathy (TON) in a patient on tacrolimus therapy that had an exhaustive workup not revealing any additional cause. The patient was a 60-year-old man post-cardiac transplantation who presented with a 5-month history of vision loss OD and 10 days of vision loss OS. Dilated exam showed significant optic disc edema in both eyes (OCT RNFL 442 μm OD and 330 μm OS). Multiple lumbar punctures showed a normal opening pressure. After discontinuation of tacrolimus, he noticed gradual improvement in his vision and 10-month follow-up revealed significantly improved visual function and resolved optic disc edema. This case report adds significant optic disc edema to the clinical characteristics of TON. TON should be suspected in any patient on this medication with a new optic neuropathy and negative workup for infectious or inflammatory causes. Discontinuation of the medication and change to cyclosporine can result in improvement in vision.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it