Central retinal artery occulusion after spinal surgery

Sys, J.; Michielsen, Joris; Mertens, E.; Verstreken, J; Tassignon, Marie-José

doi:10.1007/bf00307832

Cited by 24 publications

(12 citation statements)

References 6 publications

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“…Ocular compression may precipitate acute retinal arterial ischemia in some patients undergoing spine surgery in the prone position (31,32). In rare instances, acute retinal arterial ischemia has been reported to occur after dental or facial cosmetic procedures, following inadvertent injection of drugs or filling materials into a facial vessel (33).…”

Section: Etiologymentioning

confidence: 99%

Acute retinal arterial ischemia

Dattilo¹,

Newman²,

Biousse³

2018

Ann. Eye Sci

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Acute retinal arterial ischemia, which includes transient monocular vision loss (TMVL), branch retinal artery occlusion (BRAO), central retinal artery occlusion (CRAO) and ophthalmic artery occlusion (OAO), is most commonly the consequence of an embolic phenomenon from the ipsilateral carotid artery, heart or aortic arch, leading to partial or complete occlusion of the central retinal artery (CRA) or its branches. Acute retinal arterial ischemia is the ocular equivalent of acute cerebral ischemia and is an ophthalmic and medical emergency. Patients with acute retinal arterial ischemia are at a high risk of having further vascular events, such as subsequent strokes and myocardial infarctions (MIs). Therefore, prompt diagnosis and urgent referral to appropriate specialists and centers is necessary for further work-up (such as brain magnetic resonance imaging with diffusion weighted imaging, vascular imaging, and cardiac monitoring and imaging) and potential treatment of an urgent etiology (e.g., carotid dissection or critical carotid artery stenosis). Since there are no proven, effective treatments to improve visual outcome following permanent retinal arterial ischemia (central or branch retinal artery occlusion), treatment must focus on secondary prevention measures to decrease the likelihood of subsequent ischemic events.

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Section: Etiologymentioning

confidence: 99%

Acute retinal arterial ischemia

Dattilo¹,

Newman²,

Biousse³

2018

Ann. Eye Sci

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“…It is seen in spine surgery performed with the patient in prone position. [5–7] Various factors which increase the vulnerability for external compression include altered facial anatomy, osteogenesis imperfecta, and exophthalmos. Patients belonging to Asian descent tend to have lower nasal bridges, which may increase the risk of external compression.…”

Section: Causes Of Vision Loss After Spine Surgerymentioning

confidence: 99%

Perioperative vision loss: A complication to watch out

Grover

Jangra

2012

J Anaesthesiol Clin Pharmacol

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Postoperative vision loss, a rare but devastating complication, has been reported after spine, cardiac, and head–neck surgeries. Its incidence following spine surgeries exceeds that after cardiothoracic surgeries. Various causes attributed to postoperative blindness include ischemic optic neuropathy, central or branch retinal artery occlusion, cortical blindness, and rarely external ocular injury. Other contributory factors described are microvascular diseases and intraoperative hemodynamic compromise. However, the exact association of these factors with postoperative blindness has not yet been confirmed. In this review, we describe causes, presentation, and treatment of postoperative blindness and also recommend practical guidelines to avoid this complication. The search strategies for this review included both search of electronic databases as well as manual search of relevant articles.

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“…[2][3][4][5][6][7][8][9][10][11][12][13] With the exception of proximal embolism from the ipsilateral internal carotid artery in cardiac surgery patients, the most common etiology of perioperative CRAO is direct external pressure on the eye. In these instances, the intraocular pressure exceeds systemic blood pressure, thereby decreasing blood flow through the central retinal artery with resultant retinal ischemia and vision loss.…”

mentioning

confidence: 99%

The Incidence of Vision Loss due to Perioperative Ischemic Optic Neuropathy Associated With Spine Surgery

Chang

Miller

2005

Spine

146

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POION is a rare but potentially devastating and untreatable complication of spine surgery, particularly that performed with the patient in the prone position. Anemia, hypotension, long duration of surgery, and significant intraoperative hydration may all be risk factors for this condition. All patients undergoing spine surgery should be informed about the low but definite risk of this condition, and every attempt should be made during surgery to maintain stable hemoglobin and mean arterial pressure and to avoid overhydration.

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Central retinal artery occulusion after spinal surgery

Cited by 24 publications

References 6 publications

Acute retinal arterial ischemia

Acute retinal arterial ischemia

Perioperative vision loss: A complication to watch out

The Incidence of Vision Loss due to Perioperative Ischemic Optic Neuropathy Associated With Spine Surgery

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