Perioperative visual loss following prone spinal surgery: A review

Epstein, Nancy E.

doi:10.4103/2152-7806.182550

Cited by 55 publications

(41 citation statements)

References 37 publications

(64 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are multiple risk factors developing POVL in prone position. However, the patient in this case did not possess these recognized or suspected risk factors, for example, obesity, prolonged operative times, diabetes, and so on [3]. During the operation, his hemodynamic was tightly controlled and maintained stably without greater blood loss.…”

Section: Conclusion and Literature Reviewmentioning

confidence: 85%

“…Although POVL in prone position following spinal surgery is rare, this complication is a disaster, which might be irreversible and seriously reduce quality of life. In 2016 Epstein and colleague [3] reviewed 20 cases of blindness with spine surgery, unexpectedly 8 patients were permanent visual loss postoperatively. Consequently it has to be paid more attention on this complication.…”

Section: Conclusion and Literature Reviewmentioning

confidence: 99%

“…ION is the most frequently cited cause of POVL under GA [9]. No less than 89% of all POVL is attributed to ION, which including anterior ION and posterior ION depending on the location of lesion [3,5].…”

Section: Conclusion and Literature Reviewmentioning

confidence: 99%

“…Visual loss after spine surgery is attributable to various risk factors, including excessive blood loss, long prone spine surgery, hypoxia, use of vasoconstrictors, hypotension, high venous pressure, high volume fluid replacement, and poor head positioning [3]. These risks might lead to ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO) and retinal vein occlusion.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

Xiong

Guo²,

Hu³

et al. 2020

Preprint

View full text Add to dashboard Cite

KEYWORDS 2 postoperative visual loss, visual acuity, ischemic optic neuropathy, retinal artery occlusion, prone position, spine surgery Abstract Background: Visual loss after spine surgery in prone position is disastrous postoperative complication because it is almost irreversible. Meamwhile, there is no optimal treatments and recommended peofessional guidelines. Case presentation: A 43 years old male patient complained visual loss after spine surgery in prone position. Immediate ophthalmic consultation undoubtedly considered central retinal artery occlusion, therefore combined therapies were administered including neurotrophy, anticoagulation, vasodilation and adequate fluid infusion, followed by hyperbaric oxygen treatment. After active treatment, his visual acuity recovered from postoperative 5 hours gradually. Conclusion: Because there is shortage of efficacious treatment against visual loss after spine surgery in prone position, the best method avoiding this complication is to pay great attention and prevent it. Background Visual loss after spine surgery in prone position is a rare complication, this incidence is about 0.017 to 1% [1, 2]. Although rare, it is potentially disastrous postoperative complication, even irreversible. Visual loss after spine surgery is attributable to various risk factors, including excessive blood loss, long prone spine surgery, hypoxia, use of vasoconstrictors, hypotension, high venous pressure, high volume fluid replacement, and poor head positioning [3]. These risks might lead to ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO) and retinal vein occlusion. It has been reported patients with carotid stenosis or occlusion is also more vulnerable to this complication than those without stenosis [4]. Although CRAO and ION might be the ordinal mechanisms of postoperative visual loss (POVL) [5], the exact pathophysiologic mechanism has not been revealed [6]. Now we presented a case suffering transient unilateral visual loss after spine surgery in prone position under general anesthesia (GA), although who was without these recognized perioperative risk factors. Because of timely diagnosis and therapy, his visual acuity (VA) mostly resolved soon. This was a lucky case because of very quick recovery, which different from the most reported cases. Meanwhile possible etiologies and effective treatments were analyzed for avoiding this complication in future. Case PresentationA 43-year-old man was admitted with complain of repeated numb and pain on left low limb and

show abstract

Section: Conclusion and Literature Reviewmentioning

confidence: 85%

Section: Conclusion and Literature Reviewmentioning

confidence: 99%

Section: Conclusion and Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

Xiong

Guo²,

Hu³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…10 Previously identified risk factors for ION include age, transfusion, male sex, increased anesthetic duration, greater estimated blood loss, use of a Wilson frame, anemia, diabetes mellitus, prolonged operative times, and obesity. [10][11][12] The most recent data derived from the Nationwide Inpatient Sample from 1998 to 2012 identified age, male sex, transfusion, and obesity as risk factors. 10 Although our understanding of risk factors associated with frank vision loss after spine surgery has improved substantially in the last 20 years, far less is known about perioperative ocular injuries not associated with vision loss.…”

Section: Résumémentioning

confidence: 99%

Ocular injury during spine surgery

Höfer

Evans

Warner

2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose Ocular injury and vision loss are rare complications of surgery. Spine surgery has been identified as particularly high risk for postoperative vision loss; nevertheless, ocular injuries have not been comprehensively assessed in this patient population. Methods This historical cohort study assessed incidence, cause, and risk factors of perioperative ocular injury after spine surgery at a tertiary care medical centre from January 1, 2006 through January 31, 2018. Patients were included who had ocular injury identified during an ophthalmology consultation in the first seven postoperative days. Differences in demographic, laboratory, intraoperative, and postoperative characteristics between those experiencing or not experiencing ocular injury were assessed with Fisher exact and Wilcoxon signed-rank tests for categorical and continuous variables, respectively. Results Of 20,128 qualifying spine surgeries, 39 cases of perioperative ocular injuries were identified (39/20,128; 0.19% [95% confidence interval (CI), 0.14 to 0.26]). The most common ocular injury was blurry vision of unknown cause (13/39; 33%; 95% CI, 18.6 to 46.4), followed by ischemic optic neuropathy (9/39; 23%; 95% CI, 12.6 to 38.3) and corneal abrasion (7/39; 18%; 95% CI, 9.0 to 32.7). All cases of blurry vision of unknown cause were diagnosed via ophthalmology consultation and resolved within several days. Patients with perioperative ocular injury were more likely to have baseline anemia, have undergone fusion and instrumentation procedures, and had longer operative times with greater crystalloid, colloid, and transfusion requirements and more blood loss.

show abstract

Eye Protection for Patients With COVID-19 Undergoing Prolonged Prone-Position Ventilation

2021

View full text Add to dashboard Cite

any severely ill patients with coronavirus disease 2019 (COVID-19) experience rapid progression of viral pneumonia leading to acute respiratory distress syndrome. Among those with severe acute respiratory distress syndrome unresponsive to maximum optimal ventilator settings, prolonged prone positioning (at least 16 hours per day) is one of the adjunctive strategies to improve oxygenation. 1 COVID-19 is associated with a high prevalence of coagulopathy and thromboembolism that may contribute to respiratory deterioration. 2 This hypercoagulable state, which occurs more often in patients with elevated fibrinogen and dimerized plasmin fragment D levels, can cause widespread

show abstract

Perioperative visual loss following prone spinal surgery: A review

Cited by 55 publications

References 37 publications

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

Ocular injury during spine surgery

Eye Protection for Patients With COVID-19 Undergoing Prolonged Prone-Position Ventilation

Contact Info

Product

Resources

About