Anterior ischaemic optic neuropathy after coronary artery bypass graft: the role of anaemia in diabetics

Abstract

Purpose To ascertain factors associated with anterior ischaemic optic neuropathy (AION) following coronary artery bypass graft (CABG) in a Lebanese population. Methods A retrospective chart review of consecutive CABG performed over a 5-year period (1995)(1996)(1997)(1998)(1999) in one medical centre.

Perioperative optic neuropathy in patients undergoing off-pump coronary artery bypass graft surgery

“…[19] Diabetes can cause intrinsic small vessel disease and is generally accepted as a risk factor for AION. [2,14,19] Kalyani et al, in their series of patients with CPB-associated PON, did not find an increased risk in diabetics. [7] They found that patients with vascular disease and those who had an absolute drop in hemoglobin had an increased risk of PON.…”

“…[1][2][3][4] Most of the information about perioperative ischemic optic neuropathy is from case reports and a few case control studies. [1,2,[6][7][8][9][10][11][12][13][14][15] The American Society of Anesthesiologists (ASA) post-operative the Institutional Review Board, we retrospectively analyzed the case records of patients who underwent OPCABG over a 10-month period from October 2008 to August 2009 at our tertiary care cardiac center. The following information was abstracted from the case records: Pre-operative comorbidities, including diabetes, hypertension, peripheral vascular disease [ Table 1]; intra-operative anesthesia, and monitoring details of hemodynamic parameters including mean arterial pressure (MAP), arterial blood gas analysis, blood glucose level, hematocrit (Hct), temperature, urine output, inotropic support agent (s), blood and blood component administered; surgical information such as use of myocardial stabilizer, heparin-protamine administered, number of vessels grafted, episodes and duration of hypotension and intra-operative events if any.…”

Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report

“…Different authors [ 23 – 26 ] found postoperative anemia to be a predisposing cause for AION. Mansour et al reported that severe anemia in patients undergoing CABG appears to be a risk factor for AION, especially in diabetics, and needs prompt correction to prevent or reverse ischemic ocular events [ 27 ]. However, in our case the hematocrit and hemoglobin values were much higher than that reported in previous papers.…”

Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements

“…5-7 Most of the previous reports related to ocular problems after cardiac surgery focused on the individual patients who had visual loss due to ischemic optic neuropathy. 4,8 But, in this study, rather than obtaining data about the diseased eyes from the patient records, we compared various ocular parameters related to perfusion between CABG surgery patients and healthy controls.…”