Posterior ischaemic optic neuropathy: clinical features, pathogenesis, and management

Hayreh, Sohan Singh

doi:10.1038/sj.eye.6701562

Cited by 208 publications

(167 citation statements)

References 61 publications

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“…42 Just how low or for how long the haemoglobin concentration must decrease to lead to this complication is not known. Myers and colleagues' study reported higher intraoperative blood loss in patients with visual loss after spine surgery compared with those without.…”

Section: Blood Lossmentioning

confidence: 99%

Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

255

116

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Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions. Br J Anaesth 2009; 103 (Suppl. 1): i31-i40Keywords: complications, neurological; complications, neuropathy; eye, intraocular pressure; eye, pupil; surgery, spinal Visual loss after anaesthesia and surgery is a rare, unexpected, and devastating complication. Clinicians have suspected that incidence is increasing, particularly with spinal fusion surgery; however, recent data suggest that this may not be the case. This review will update readers on the incidence, suspected risk factors, diagnosis, and treatment of perioperative visual loss (POVL), in the setting of non-ocular surgery. The causes of POVL are primarily retinal vascular occlusion (RVO) and ischaemic optic neuropathy (ION). The relevant anatomy of the ocular circulation has been reviewed elsewhere and is summarized in Figure 1. 80 Other sources are glycine toxicity during transurethral resection of the prostate, acute angle closure glaucoma, cortical blindness, and expansion of an intraocular sulphur hexafluoride vitrectomy bubble by administration of nitrous oxide. As these are less common, the reader is referred for details to a recent more inclusive review. 80

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Section: Blood Lossmentioning

confidence: 99%

Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

255

116

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“…All patients were older than 62 years. other studies [5,22]. In a study by Hayreh, from 85 biopsy-confirmed patients there were only six (7%) patients with PION [5].…”

Section: Discussionmentioning

confidence: 99%

“…In the arteritic AION (A-AION) eyes visual field defect depends upon the area of the optic nerve head supplied by the occluded posterior ciliary artery, which varies widely from eye to eye [21]. The most common visual field defect in arteritic and nonarteritic PION is central visual loss, alone or in combination with other types of visual field defects, and much less commonly the reverse pattern, i.e., the central field normal with marked loss of peripheral fields [22]. The purpose of this study was to investigate visual field defects in different clinical presentations of giant cell arteritis.…”

Section: Introductionmentioning

confidence: 99%

Visual fields in giant cell arteritis (Horton’s disease)

Fakin

Kerin

Hawlina

2011

Translational Neuroscience

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Background: The purpose of this study was to investigate visual field defects in different clinical presentations of giant cell arteritis. Methodology: Retrospective study of 36 patients from 1996 -2010 with giant cell arteritis (67% female, average age 79, range 62-92 years), with typical clinical picture and/or positive biopsy (78%, 18/23 performed). Visual fields charted by Goldmann perimeter were categorized into specific categories. Respect for horizontal meridian was noted.

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“…Interestingly, ophthalmic examination revealed central scotoma, a characteristic visual disturbance that suggested ischemic damage as the likely pathogenesis of optic nerve involvement. 12 Though the exact reason for our patient's unilateral visual disturbance is uncertain, the severity of impairment of the vascular system penetrating the dura mater and/or the diŠerence in vascular anastomosis may contribute to the pathogenesis of optic nerve impairment.…”

Section: Discussionmentioning

confidence: 99%

Reversible Distension of the Subarachnoid Space around the Optic Nerves in a Case of Idiopathic Hypertrophic Pachymeningitis

et al. 2012

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Idiopathic hypertrophic pachymeningitis (IHP) is a chronic in‰ammatory disease of unknown cause. We report a case of IHP with bilateral distended subarachnoid space (SAS) of the optic nerves and unilateral visual disturbance. We observed marked amelioration of magnetic resonance (MR) imagingˆndings after initiation of treatment with prednisolone. This radiologicalˆnding implicates optic nerve sheath involvement that aŠects cerebrospinal ‰uid (CSF) dynamics around the optic nerve.

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Posterior ischaemic optic neuropathy: clinical features, pathogenesis, and management

Cited by 208 publications

References 61 publications

Perioperative visual loss: what do we know, what can we do?

Perioperative visual loss: what do we know, what can we do?

Visual fields in giant cell arteritis (Horton’s disease)

Reversible Distension of the Subarachnoid Space around the Optic Nerves in a Case of Idiopathic Hypertrophic Pachymeningitis

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