Bilateral central scotoma with preservation of central vision in 2 patients following caesarian section under spinal anesthesia

Abstract

Two female patients are described with acute bilateral central scotomata with preservation of central vision following spinal anesthesia. Both patients had a temporary drop in systemic blood pressure and underwent caesarean section with moderate blood loss. In order to explain the visual field defects extensive ophthalmological examination and CT-scanning with nuclear magnetic resonance imaging were performed. The hypothetical explanation for the visual field defects is transient macular ischemia.

Two cases of acute macular neuroretinopathy

“…To our knowledge, there is only one previous report in the literature of two cases of AMNR occurring following postpartum hypotension. 4 A follow-up of 28 months allowed collection of detailed longitudinal data on AMNR after C-section in the first case. Our patient suffered from constant hypotension with no documented acute drop in blood pressure prior to the onset of her complaints.…”

“…2,3 Several risk factors have been reported, ranging from viral illness and the use of epinephrine to acute episodes of hypotension. 4 The lesions may be located in the outer neurosensory retina as suggested by optical coherence tomography (OCT) and multifocal electroretinography (mfERG). [5][6][7][8] Here, we describe two young females with AMNR.…”

Temporary Vision Loss After Spinal Anesthesia

“…Supin pozisyonda yapılan Stilma ve ark. 'nın olgularında ise santral görüşün korunduğu fakat bilateral akut santral skotomun oluştuğu bildirilmiştir (4).…”

Caudal Epidural Steroid Injections-A Mini Review

“…Large volumes have been associated with complications like increase in the intraocular pressure with retinal haemorrhage [27][28][29][30][31][32]; however, no studies were found comparing the differential values of the anesthetic drug and the normal saline. Manchikanti et al [15] did a study to estimate the filling patterns of the lumbosacral epidural space by injecting nonionic contrast.…”