Severe bilateral optic nerve and retinal hypoperfusion in a patient with acute respiratory distress syndrome and septic shock.
Am J Ophthalmol Case Rep
; 6: 84-87, 2017 Jun.
Article
in En
| MEDLINE
| ID: mdl-29260067
ABSTRACT
PURPOSE:
To report a case of bilateral central retinal artery occlusion with both anterior and posterior ischemic optic neuropathy. OBSERVATIONS A 65-year-old Caucasian woman presented with acute respiratory distress syndrome and septic shock. After treatment with vasopressors and prolonged prone positioning, she was noted to be bilaterally completely blind on hospitalization day 12. Evaluation revealed evidence of bilateral central retinal artery occlusion and bilateral ischemic optic neuropathy. Magnetic resonance imaging of the orbits demonstrated severe restricted diffusion of both optic nerves consistent with ischemia. Both central retinal artery occlusion and ischemic optic neuropathy have been reported in cases of severe hypotension, blood loss, and prone positioning, most often postoperatively after spinal surgery. CONCLUSIONS AND IMPORTANCE To our knowledge, this is the first reported case of bilateral central retinal artery occlusion with both anterior and posterior ischemic optic neuropathy, presumed due to the combination of severe systemic hypotension, hypoxemia due to the respiratory distress syndrome, and prolonged prone positioning.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Am J Ophthalmol Case Rep
Year:
2017
Document type:
Article