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Perioperative optic nerve ischemia

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https://www.readbyqxmd.com/read/25893178/complications-associated-with-prone-positioning-in-elective-spinal-surgery
#1
REVIEW
J Mason DePasse, Mark A Palumbo, Maahir Haque, Craig P Eberson, Alan H Daniels
Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery...
April 18, 2015: World Journal of Orthopedics
https://www.readbyqxmd.com/read/24829872/perioperative-visual-loss-after-spine-surgery
#2
REVIEW
Travis J Nickels, Mariel R Manlapaz, Ehab Farag
Perioperative visual loss (POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult to determine. According to the American Society of Anesthesiologists Postoperative Visual Loss Registry, the most common causes of POVL in spine procedures are the two different forms of ischemic optic neuropathy: anterior ischemic optic neuropathy and posterior ischemic optic neuropathy, accounting for 89% of the cases...
April 18, 2014: World Journal of Orthopedics
https://www.readbyqxmd.com/read/22090093/-perioperative-visual-loss-after-nonocular-surgery
#3
S Shmygalev, A R Heller
Perioperative visual loss (POVL) after nonocular surgery is a rare but unexpected event and represents a devastating complication. It is most often associated with cardiac, spinal as well as head and neck surgery. The etiology of POVL remains incompletely understood. Any portion of the visual system may be involved, from the cornea to the occipital lobe. The most common site of permanent injury is, however, the optic nerve itself and ischemia is the most often presumed mechanism. Multiple factors have been proposed as risk factors for POVL, including long duration in the prone position, decreased ocular perfusion pressure, excessive blood loss and anemia, hypotension, hypoxia, excessive fluid replacement, elevated venous pressure, head positioning and a patient-specific vascular susceptibility which may be anatomic or physiologic...
November 2011: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/21695490/-perioperative-visual-loss-after-nonocular-surgery
#4
REVIEW
S Shmygalev, A R Heller
Perioperative visual loss (POVL) after nonocular surgery is a rare but unexpected event and represents a devastating complication. It is most often associated with cardiac, spinal as well as head and neck surgery. The etiology of POVL remains incompletely understood. Any portion of the visual system may be involved, from the cornea to the occipital lobe. The most common site of permanent injury is, however, the optic nerve itself and ischemia is the most often presumed mechanism. Multiple factors have been proposed as risk factors for POVL, including long duration in the prone position, decreased ocular perfusion pressure, excessive blood loss and anemia, hypotension, hypoxia, excessive fluid replacement, elevated venous pressure, head positioning and a patient-specific vascular susceptibility which may be anatomic or physiologic...
July 2011: Der Anaesthesist
https://www.readbyqxmd.com/read/21297131/blood-flow-measurements-within-optic-nerve-head-during-on-pump-cardiovascular-operations-a-window-to-the-brain
#5
Ioannis Nenekidis, Martial Geiser, Charles Riva, Constantin Pournaras, Evangelia Tsironi, Georgios Vretzakis, Vasilios Mitilis, Nikolaos Tsilimingas
This observational study is conducted to demonstrate optic nerve head (ONH) blood flow alterations during extracorporeal circulation (ECC) in routine on-pump cardiovascular operations in order to evaluate the perfusion status of important autoregulatory tissue vascular beds during moderate hypothermia. Twenty-one patients free from eye disease were prospectively enrolled in our database. Perioperative ONH blood flow measurements were performed using a hand-held portable ocular laser Doppler flowmeter just after administration of general anesthesia and during cardiopulmonary bypass (CPB) upon the lowest temperature point of moderate hypothermia...
May 2011: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/18705029/posterior-ischemic-optic-neuropathy-associated-with-migraine
#6
Rod Foroozan, Douglas P Marx, Randolph W Evans
Posterior ischemic optic neuropathy (PION) is an uncommon form of optic nerve ischemia that results from damage to the intraorbital, intracanalicular, or intracranial optic nerve. It has been reported perioperatively, in association with systemic vasculitis, and in the nonsurgical setting with no identifiable cause. Review of the literature reveals only 2 patients with PION associated with migraine in a single report. We report a patient who developed PION in the setting of a migraine headache without any other identifiable risk factors...
July 2008: Headache
https://www.readbyqxmd.com/read/18358851/perioperative-visual-loss-after-nonocular-surgeries
#7
REVIEW
Nancy J Newman
PURPOSE: To review the current knowledge of persistent visual loss after nonocular surgeries under general anesthesia. DESIGN: Perspective. METHODS: Literature review. RESULTS: The incidence of perioperative visual loss after nonocular surgeries ranges from 0.002% of all surgeries to as high as 0.2% of cardiac and spine surgeries. Any portion of the visual pathways may be involved, from the corneas to the occipital lobes, but the most common site of permanent injury is the optic nerves, and the most often presumed mechanism is ischemia...
April 2008: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/16803916/case-series-monocular-visual-loss-associated-with-subarachnoid-hemorrhage-secondary-to-ruptured-intracranial-aneurysms
#8
Chin Ted Chong, Ki Jinn Chin, Leonard W Yip, Kulgit Singh
PURPOSE: To describe variations in the presentation of monocular visual loss associated with intracranial aneurysm rupture. The clinical course, possible etiologies and management of visual loss in three patients are described. CLINICAL FEATURES: The first patient developed Terson's syndrome (vitreal hemorrhage associated with raised intracranial pressure secondary to subarachnoid hemorrhage). Following aneursymal clipping, her postoperative management was conservative and there was no improvement in visual acuity...
July 2006: Canadian Journal of Anaesthesia, Journal Canadien D'anesth├ęsie
https://www.readbyqxmd.com/read/11002492/-surgical-treatment-of-unruptured-cerebral-aneurysms-and-complications-in-patients-with-ischemic-cerebrovascular-disease
#9
K Matsumoto, K Akagi, M Abekura, T Sakaguchi, O Tasaki, T Tomishima
Patients who have unruptured intracranial aneurysms associated with ischemic cerebrovascular disease are a high-risk group for surgery. We have done clipping surgery in 15 patients among 40 with ischemic cerebrovascular disease. The criteria for surgery included an age below 65 years, CBF of more than 35 ml/100 g/min, and favorable ADL comparable to Rankin score 0-III. Two patients received simultaneous aneurysm clipping and superficial-middle cerebral artery anastomosis. Only one patient suffered from ischemia-related permanent neurological worsening, and one had direct optic nerve injury...
August 2000: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/9201834/ophthalmic-complications-after-spinal-surgery
#10
W R Stevens, P A Glazer, S D Kelley, T M Lietman, D S Bradford
STUDY DESIGN: A retrospective review of 3450 spinal surgeries was performed. OBJECTIVES: To review ophthalmic complications and their etiologies, as well as treatments and outcomes, in patients who have undergone spinal surgery. SUMMARY OF BACKGROUND DATA: Ophthalmic complications after major spinal reconstructive surgery are rare and have not been adequately addressed in the orthopedic literature. METHODS: In a series of 3450 spinal surgeries at three institutions, the authors identified seven patients (incidence = 0...
June 15, 1997: Spine
https://www.readbyqxmd.com/read/8619766/visual-field-loss-following-vitreous-surgery
#11
J B Kerrison, J A Haller, M Elman, N R Miller
OBJECTIVE: To assess possible causes of visual field loss following vitreous surgery. DESIGN: Charts of 8 patients prospectively identified, who developed visual field loss following vitreous surgery, were reviewed to characterize this newly recognized syndrome and assess possible causes. RESULTS: Two patients had preexisting chronic open-angle glaucoma and 1 had ocular hypertension. Indications for surgery included 4 eyes with macular holes, 1 eye with epiretinal membrane, 2 eyes with rhegmatogenous retinal detachment, and 1 eye with retinal detachment and giant retinal tear...
May 1996: Archives of Ophthalmology
https://www.readbyqxmd.com/read/8029632/-irreversible-bilateral-blindness-after-functional-neck-dissection-apropos-of-a-case-and-a-review-of-the-literature
#12
REVIEW
M Bouzaiene, A Deboise, A Kheyar, F Le Queau, M Lemogne, S Baudoin Lacour
Postoperative blindness due to ischemic optic neuropathy is a rare and dramatic complication. A review of the literature from 1960 until nowadays reveal several physiopathological mechanisms of the blindness. Through the description of their clinic case of a fourty seven years old man showing definitive postoperative blindness after sustaining surgery for epidermoid carcinoma of the mouth floor, the authors suggest as etiology the conjunction of the following factors: brain venous high pressure, head and neck oedema, hypotension and the vascular state of the patient...
1994: Revue de Stomatologie et de Chirurgie Maxillo-faciale
https://www.readbyqxmd.com/read/3625884/the-role-of-external-carotid-revascularization-in-the-treatment-of-ocular-ischemia
#13
D L Street, J J Ricotta, R M Green, J A DeWeese
During the past 13 years, 16 patients with visual disturbances, ipsilateral internal carotid artery (ICA) occlusion, and external carotid artery (ECA) stenosis have had ECA reconstruction. Indications for operation included amaurosis fugax (AF) in five patients, AF and transient ischemic attacks in four patients, ischemic optic neuropathy in two patients, retinal artery occlusion in one patient, and blurry vision and scotomata in four patients. In 12 cases (75%), there were hemodynamically significant contralateral ICA lesions, including four contralateral ICA occlusions...
September 1987: Journal of Vascular Surgery
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