Anterior Ischemic Optic Neuropathy: A Complication after Systemic Inflammatory Response Syndrome

Cullinane, Daniel C.; Jenkins, Judith M.; Reddy, Sreenath; VanNatta, Timothy; Eddy, Virginia A.; Bass, John G.; Chen, Ashton; Schwartz, Mark D.; Lavin, Patrick; Morris, John A.

doi:10.1097/00005373-200003000-00003

Cited by 35 publications

(28 citation statements)

References 15 publications

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“…A summary of individual case reports 80 Case series and reviews have been published involving all types of surgery, 33 86 and case-control studies 50 in spine surgery (case series; 20 48 61 case-control study 70 ), cardiac surgery (case series; 52 case-control 72 88 ), and in trauma patients. 24 …”

Section: Ischaemic Optic Neuropathymentioning

confidence: 99%

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Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

253

116

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Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions. Br J Anaesth 2009; 103 (Suppl. 1): i31-i40Keywords: complications, neurological; complications, neuropathy; eye, intraocular pressure; eye, pupil; surgery, spinal Visual loss after anaesthesia and surgery is a rare, unexpected, and devastating complication. Clinicians have suspected that incidence is increasing, particularly with spinal fusion surgery; however, recent data suggest that this may not be the case. This review will update readers on the incidence, suspected risk factors, diagnosis, and treatment of perioperative visual loss (POVL), in the setting of non-ocular surgery. The causes of POVL are primarily retinal vascular occlusion (RVO) and ischaemic optic neuropathy (ION). The relevant anatomy of the ocular circulation has been reviewed elsewhere and is summarized in Figure 1. 80 Other sources are glycine toxicity during transurethral resection of the prostate, acute angle closure glaucoma, cortical blindness, and expansion of an intraocular sulphur hexafluoride vitrectomy bubble by administration of nitrous oxide. As these are less common, the reader is referred for details to a recent more inclusive review. 80

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Section: Ischaemic Optic Neuropathymentioning

confidence: 99%

“…Trauma patients with visual loss after massive blood replacement have been reported. 24 Analysis is complicated because of numerous systemic alterations. Four burn patients with 25% body surface area burns and massive fluid resuscitation had IOP .30 mm Hg 48 h after admission, all of whom received .27 litre of i.v.…”

Section: Haemodilutionmentioning

confidence: 99%

Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

253

116

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“…4 Anterior ischemic optic neuropathy has 2 types: arteritic (due to giant cell arteritis) and nonarteritic (due to other causes and much more common). 5,6 Posterior ischemic optic neuropathy has 3 subtypes: arteritic (due to giant cell arteritis); nonarteritic (the most common type); and surgical, postoperative, or perioperative (associated with various extraocular surgical procedures). [7][8][9] Blood supply to the posterior optic nerve is almost entirely dependent on the pial vasculature, which is very susceptible to ischemia.…”

Section: Discussionmentioning

confidence: 99%

A Young Man With Severe and Disabling Complications of Septic Shock

Haas

Ploeg

Quak

et al. 2015

American Journal of Critical Care

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M ost patients discharged from critical care, particularly after septic shock, experience problems with physical, psychosocial, and emotional functioning. We report on bilateral blindness and unilateral sensorineural hearing loss as rare but severely disabling complications in a young survivor of septic shock. Case ReportA 42-year-old man with a history of psoriatic arthritis, for which he used methotrexate (2.5 mg once a week), came to the emergency department with abdominal pain 2 days after endoscopic repair of an inguinal hernia on the left side. Laboratory examination revealed an elevated level of C-reactive protein (51 mg/L, reference value < 10 mg/L; to convert to nanomoles per liter, multiply by 9.524) and leukocytosis (13.9 x 10 9 /L; reference value, 4.0-10.0 x 10 9 /L), with an elevated level of neutrophils (12.6 x 10 9 /L; reference value, 1.3-5.7 x 10 9 /L) among others. Ultrasound showed a fluid collection in the abdominal wall, thought to indicate a rectus hematoma.The patient was admitted to the surgical care area for observation and analgesia, but clinical deterioration occurred and septic shock developed within 12 hours of admission. The patient was admitted to the intensive care unit (ICU) and resuscitated with fluids and vasopressors. Antibiotics (ceftriaxone and metronidazole) were administered to treat Abstract A young man had severe septic shock with multiorgan failure due to necrotizing fasciitis caused by group A streptococcus after endoscopic repair of a preperitoneal inguinal hernia. He was treated with surgical exploration and antibiotics and resuscitated with fluids, vasopressors, and inotropic agents. He survived this critical illness, but when he woke up from sedation, his vision was lost in both eyes. Ophthalmological evaluation revealed minimal peripapillary retinal hemorrhages without signs of papillary edema. Visually evoked potentials were negative. Magnetic resonance imaging did not show a cause of the visual damage. The patient had bilateral ischemic optic neuropathy diagnosed. Two weeks later, unilateral sudden deafness also developed. The acquired blindness and hearing loss were unchanged after more than 1 year and seem to be permanent, severely disabling this young survivor of septic shock. (American Journal of Critical Care. 2015;24:450-452) Cases of Note Cases of Note features peer-reviewed case reports and case series that document clinically relevant findings from critical and high acuity care environments. Cases that illuminate a clinical diagnosis or a management issue in the treatment of critically and acutely ill patients and include discussion of the patient's experience with the illness or intervention are encouraged. Proposals for future Cases of Note articles may be e-mailed to ajcc@aacn.org. a suspected abdominal infection and an emergency laparotomy was performed, which showed turbid fluid but no perforation or abscess. The mesh was removed and culture samples were taken. When cultures revealed hemolytic group A streptococcus, antibiotic treatment was swi...

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“…Anterior ION is caused by infarction of the optic nerve head resulting from occlusion of the short posterior ciliary arteries. Posterior ION is characterized by ischemia to the retrolaminar portion of the optic nerve, which is supplied by the surrounding pial capillary plexus [63,64].…”

Section: Ischemic Optic Neuropathymentioning

confidence: 99%