MRI findings of bilateral posterior ischemic optic neuropathy in postcardiac transplant patient.

ABSTRACT

INTRODUCTION: Posterior ischemic optic neuropathy (PION) is a rare complication of prolonged surgical hypotension. It can occur in patients who have undergone nonocular surgery, particularly associated with significant blood loss, prolonged anesthesia time, and hypotension. CASE REPORT We report a 48-year-old female patient who developed postoperative visual loss after cardiac transplantation. Her operative course was marked by prolonged hypotension. The patient's symptoms did not manifest until she was off sedatives. The initial ophthalmoscopic examination performed was normal. Magnetic resonance imaging confirmed the presence of restricted diffusion in both optic nerves consistent with bilateral PION. CONCLUSIONS: PION remains a difficult clinical diagnosis to prove. We report a magnetic resonance imaging-confirmed case of bilateral PION. Radiologic findings, especially diffusion-weighted images, can assist in the early identification of diffusion changes in ischemic optic nerves.