Bilateral blindness after cardiopulmonary bypass

Lund, Philip E.; Madsen, Karin E.

doi:10.1016/1053-0770(94)90287-9

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…The aetiology of ischaemic optic neuropathy postoperatively is unclear and probably multi-factorial. Major risk factors include anaemia, hypotension and external compression 2,5,8,12 . Duration of surgery, atherosclerosis, hypertension and diabetes are also considered possible contributing factors 8,12 .…”

Section: Discussionmentioning

confidence: 99%

Alert for Perioperative Visual Loss: An Unusual Presentation of an Orbital Haemangioma during Spinal Surgery

Greenberg

Tymms

2003

Anaesth Intensive Care

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A 62-year-old man with a history of non-insulin-dependent diabetes mellitus, hypertension and obesity, presented for elective lumbar laminectomy for spinal canal stenosis. Twenty minutes after placement in the prone position, he developed left orbital proptosis. The surgery was deferred and a subsequent CT scan showed an orbital haemangioma. This case highlights the importance of meticulous attention to eye-care for patients in the prone position.

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Section: Discussionmentioning

confidence: 99%

Alert for Perioperative Visual Loss: An Unusual Presentation of an Orbital Haemangioma during Spinal Surgery

Greenberg

Tymms

2003

Anaesth Intensive Care

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“…These are end arteries, and a "watershed" area for ischemia or infarction may occur between PCAs anywhere between the fovea and the nasal border of the optic disc, which then determines the site of optic nerve is~hemia.5~6 No definite cause of ION can be found in many patients, but medical causes include giant cell arteritis, diabetes, arteriosclerosis, hypertension, collagen vascular disease, carotid disease, and migraine; and raised intraocular pressure (IOP) or chronic edema of the optic disc which cause compression of vessels of the prepapillary choroid.7 Importantly, ION has been reported following cardiac arrest,* systemic hemorrhage, hypotension and anemia,9-15 and CPB. [16][17][18][19] Blindness because of ION was first reported in otherwise healthy soldiers who suffered severe hemorrhage with war injury,gT20 in obstetric ROBINSON, ET AL. 77 BINOCULAR BLINDNESS AFTER DYNAMIC CARDIOMYOPLASTY patients following overzealous treatment of eclampsia, and in patients with antepostpartum hemorrhage.21-25 Subsequently, six reported cases occurred following bilateral radical neck dissection.…”

Section: Discussionmentioning

confidence: 99%

“…This many represent 90 to 130 cases of ION post-CPB each year in the USA. [17][18][19] In the cases reviewed, patients ranged from 44 to 61 years old. Visual complaints often occurred 4 to 6 days post-CPB, and were preceded by a fall in hematocrit (HCT) below 20%.…”

Section: Discussionmentioning

confidence: 99%

Binocular Blindness Following Dynamic Cardiomyoplasty

1996

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A 40-year-old man with viral cardiomyopathy underwent uncomplicated dynamic cardiomyoplasty. On the third postoperative day, he was rescued from an 8-hour period of severe cardiogenic shock. Eleven days postoperatively, he was withdrawn and uncooperative, preferring to be left alone. He then complained of total blindness, which persisted to his sudden death on postoperative day 26. Clinical examination revealed no neurological abnormality except for signs consistent with a diagnosis of ischemic optic neuropathy. The optic nerve in the scleral canal is especially vulnerable to hypoperfusion. Blindness has been reported following severe hemorrhage, bilateral neck dissection, and has an incidence of 1 per 1100 cases following cardiopulmonary bypass. Anemia and hypotension may be consistent risk factors predisposing patients to this catastrophic complication.

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“…In this paper, we report the clinical characteristics of subjects with AION following CABG performed over a 5-year period, and compare them to subjects free from AION during the same period, as well as to cases reported in the literature. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] A better understanding of the factors associated with postoperative AION can aid in the development of preventive and therapeutic measures.…”

Section: Introductionmentioning

confidence: 99%