Visual Field Defect after Cardiac Surgery: The Striking Role of Interdisciplinary Collaboration

Case Reports in Ophthalmological Medicine
Raffaele Nuzzi, Carlo Lavia

Abstract

Perioperative visual loss (POVL) is a potentially devastating complication that can occur following ocular or nonocular surgery. The leading causes of this disease are retinal vascular occlusions, ischemic optic neuropathies, and cortical blindness. POVL pathogenesis is strictly influenced by surgery, anesthesia, and patients' comorbidities. We report of a 55-year-old caucasian man who presented with complaints of sudden painless loss of vision and unilateral campimetric deficit. We recorded a preserved visual acuity but at fundus examination a bilateral ischemic optic neuropathy (ION) was suspected. Our hypothesis was supported by uncommon and peculiar visual field defects and a history of cardiovascular surgery shortly before was a striking data. When we examined his medical records we found strong accordance with what is reported in literature to be risk factors for postoperative ION development. He presented intraoperative hypotension, anemia, and hypothermia, he was older than 50 years, and surgery lasted for more than five hours. We are currently monitoring his visual acuity and visual fields which remain unchanged. As there is no proved therapy for such severe adverse events, we recommend intraoperative check of blood pr...Continue Reading

References

Oct 1, 1978·Annals of Internal Medicine·J B Reuler
Jan 15, 1989·American Journal of Ophthalmology·D Deutch, R A Lewis
Sep 29, 2001·Anesthesiology·L A Lee, A M Lam

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BETA
coronary bypass
amputation

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