Bilateral Anterior Ischaemic Optic Neuropathy in a Child on Continuous Peritoneal Dialysis: Case report and literature review

Al-Kaabi, Abdullah; Haider, Agha S.; Shafeeq, Mohammed O.; El-Naggari, Mohammed A.; Elnour, Ibtisam; Ganesh, Anuradha

doi:10.18295/squmj.2016.16.04.018

Cited by 12 publications

(16 citation statements)

References 23 publications

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“…To date, 22 cases of AION have been reported in children, all of whom were on peritoneal dialysis. Similarities of our case with the previously reported 22 cases are the 2 Case Reports in Nephrology bilateral nature of vision loss in 95% (21/22) of patients and sudden presentation in all patients [1,[3][4][5]. As with our case, 77% (17/22) of the cases also presented with hypotension, further supporting systemic hypotension as a risk factor for AION.…”

Section: Discussionsupporting

confidence: 90%

“…e mean age of patients was 3.3 years. Of the 21 patients available for follow-up, 62% (13/21) had partial vision recovery, as did our patient, and 38% (8/21) remained blind [1,[3][4][5]. e optic disc pallor seen at presentation in our case has been reported previously in acute pediatric AION related to dialysis [3].…”

Section: Discussionsupporting

confidence: 76%

“…AION has been reported as a complication of hypotension secondary to chronic dialysis in adult patients, but it is much less common in children [2]. To our knowledge, only 22 cases of pediatric AION have been reported and all of them were receiving peritoneal dialysis [1,[3][4][5]. We present what we believe to be the first case report of AION in a child receiving chronic intermittent hemodialysis.…”

Section: Introductionmentioning

confidence: 76%

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Anterior Ischemic Optic Neuropathy in a Child Receiving Chronic Hemodialysis

Moore

Klowak

Isaza

et al. 2020

Case Reports in Nephrology

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Anterior ischemic optic neuropathy (AION) occurs due to hypoperfusion of the optic nerve and is a rare complication in patients receiving maintenance dialysis. To date, AION has only been reported in 22 children, all of whom were receiving peritoneal dialysis. We report the first case of AION in a 2-year 11-month-old child receiving chronic hemodialysis secondary to polycystic kidney disease from a phosphomannomutase 2 gene mutation. This case highlights the consideration for frequent blood pressure monitoring and ophthalmic screening in a certain cohort of children receiving chronic dialysis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 76%

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Anterior Ischemic Optic Neuropathy in a Child Receiving Chronic Hemodialysis

Moore

Klowak

Isaza

et al. 2020

Case Reports in Nephrology

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“…Infarction of the short posterior ciliary artery supplying the optic nerve head is believed to be the culprit, causing ischemia, edema, and compartment syndrome [ 33 ]. AION is subdivided into arteritic (10%) and non-arteritic (90%) causes [ 34 ]. Non-arteritic AION (NAAION) occurs in the setting of compromised blood flow associated with several comorbidities including hypertension, tobacco smoking, hypercholesterolemia, atherosclerosis, and diabetes mellitus [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…AION is subdivided into arteritic (10%) and non-arteritic (90%) causes [ 34 ]. Non-arteritic AION (NAAION) occurs in the setting of compromised blood flow associated with several comorbidities including hypertension, tobacco smoking, hypercholesterolemia, atherosclerosis, and diabetes mellitus [ 33 , 34 ]. An anatomically small or “crowded” disc has also been identified as a risk factor [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral blindness secondary to optic nerve ischemia from severe amlodipine overdose: a case report

et al. 2017

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BackgroundCalcium channel blockers are commonly prescribed medications; calcium channel blocker overdose is becoming increasingly prevalent. The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness. We describe a case of a calcium channel blocker overdose that led to bilateral cortical blindness, a presentation that has not previously been reported.Case presentationA 49-year-old white woman with known bilateral early optic atrophy presented to our hospital with hypotension and obtundation following a known ingestion of 150 mg of amlodipine. She was transferred to our intensive care unit where she was intubated, mechanically ventilated, and required maximal vasopressor support (norepinephrine 40 mcg/minute, epinephrine 40 mcg/minute, and vasopressin 2.4 units/hour) along with intravenously administered crystalloid boluses. Despite these measures, she continued to deteriorate with persistent hypotension and tachycardia, as well as anuria.Intralipid emulsion therapy was subsequently administered to which no initial response was observed. A chest X-ray revealed diffuse pulmonary edema; intravenous diuresis as well as continuous renal replacement therapy was initiated.Following the initiation of continuous renal replacement therapy, her oxygen requirements as well as urine output began to improve, and 3 days later she was liberated from mechanical ventilation. Following extubation, she complained of new onset visual impairment, specifically seeing only red-green colors, but no objects. An ophthalmologic examination revealed that this was due to bilateral optic atrophy from prolonged hypotension during the first 24 hours after the overdose.ConclusionPersistent hypotension in the setting of a calcium channel blocker overdose can lead to worsening optic atrophy resulting in bilateral cortical blindness.

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Keine generelle Empfehlung zur Nephrektomie bei pränatalem Verdacht auf ARPKD

Ebner

Liebau

2017

Urologe

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Bilateral Anterior Ischaemic Optic Neuropathy in a Child on Continuous Peritoneal Dialysis: Case report and literature review

Cited by 12 publications

References 23 publications

Anterior Ischemic Optic Neuropathy in a Child Receiving Chronic Hemodialysis

Anterior Ischemic Optic Neuropathy in a Child Receiving Chronic Hemodialysis

Bilateral blindness secondary to optic nerve ischemia from severe amlodipine overdose: a case report

Keine generelle Empfehlung zur Nephrektomie bei pränatalem Verdacht auf ARPKD

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