scholarly journals Perioperative Ischemic Optic Neuropathy

2009 ◽  
Vol 110 (2) ◽  
pp. 246-253 ◽  
Author(s):  
Sarah E. Holy ◽  
Jonathan H. Tsai ◽  
Russell K. McAllister ◽  
Kyle H. Smith

Background Ischemic optic neuropathy is the most common cause of perioperative vision loss. The authors sought to determine its incidence and identify risk factors that may contribute to perioperative ischemic optic neuropathy associated with nonophthalmologic surgical procedures at their institution. Methods Seventeen patients who experienced perioperative ischemic optic neuropathy were included in a retrospective chart review case-control study. The authors matched each patient with two control patients who had a similar surgical procedure but did not lose vision. They analyzed multiple perioperative variables for the case and control groups. Results From among 126,666 surgical procedures performed during the study period, the authors identified 17 patients with perioperative ischemic optic neuropathy, yielding an overall incidence of 0.013%. There were no hemodynamic variables that differed significantly between the ischemic optic neuropathy patients and the matched control patients. Conclusion The authors conclude that perioperative ischemic optic neuropathy can occur in the absence of atypical fluctuations in hemodynamic variables during the perioperative period.

2021 ◽  
Author(s):  
Hannah H Resnick ◽  
Mark F Bear ◽  
Eric D Gaier

Background: Recovery from amblyopia in adulthood following fellow eye (FE) vision loss is a well-known phenomenon. Incidence of recovery varies widely following different FE pathologies and rate of recovery following FE ischemic optic neuropathy (ION) has not been examined. We aimed to determine frequency and degree of improvement in amblyopic eye (AE) visual function following ION in the FE. Methods: We performed a retrospective chart review of patients between 2007-2021 confirmed to have amblyopia and ischemic optic neuropathy in different eyes. Patients with unstable ocular pathology potentially limiting vision were excluded. We compared best-corrected visual acuity (VA) in each eye before and after FE ION over time. For patients with available data, we examined change in perimetric performance over time. Results: Among the 12 patients who met inclusion criteria (mean age 67+/-8 years), 9 (75%) improved ≥1 line and 2 (17%) improved ≥3 lines. Median time from ION symptom onset to maximal improvement was 6 months (range: 2-101 months). Reliable perimetric data were available for 6 patients. Mean sensitivity improved in the amblyopic eye for all patients, with a mean improvement of 1.9+/-1.1 dB. There was no correspondence between foci of ION-related field loss and gains in field sensitivity in the AE. Conclusion: A high proportion of patients with amblyopia and contralateral ION experience improvement in their amblyopic eye. Modest gains in perimetric sensitivity in the AE may accompany FE ION. These findings support the view that residual plasticity in the adult visual cortex can be tapped to support functional improvement in amblyopia.


2017 ◽  
Vol 15 (3) ◽  
Author(s):  
Karen Bulan Reyes

Objective: This study aims to evaluate and compare the proximal, medial, and distal segments of internal carotid artery (ICA) peak systolic velocities (PSV) in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION) in one eye against the contralateral side with normal eye findings using doppler ultrasound. Methods:  This is a single-center,  prospective, case control study of five patients with unilateral NA-AION.  The peak systolic velocity (PSV) of the proximal, medial, and distal segments of the ICAs on both sides, one side with NA-AION while the contralateral side had normal eye findings, were compared and analyzed. Results: Four females and one male with a mean age of 59 years (SD = 17 years) were included. PSV of the ICA was measured in three segments: Proximal (PICA), Medial (MICA), and Distal (DICA). Mean PSV of eyes with NA-AION was 143cm/sec (SD= 177cm/sec), 159 cm/sec (SD=189 cm/sec), 98 cm/sec (SD=34cm/sec) for PICA, MICA and DICA respectively. Mean PSV of contralateral side without NA-AION was 95cm/sec (SD= 72cm/sec), 101 cm/sec (SD=53cm/sec), 140cm/sec (SD=60 cm/sec) for PICA, MICA and DICA respectively. There was no statistically significant difference between the two groups along the three segments (T-test PICAp=0.369, MICAp=0.402, DICAp=0.112). Conclusion: Mean PSV was higher in eyes with NA-AION at the proximal and medial segments of the ICA, while it was lower at the distal segments compared to the contralateral non-NA-AION side. 


2019 ◽  
Author(s):  
Ya-nan Lyu ◽  
Jing-yu Min ◽  
Yuanyuan Gong ◽  
qing Gu ◽  
fang Wei

Abstract Background: Anterior ischemic optic neuropathy (AION) is the leading cause of sudden optic nerve-related (ON-related) vision loss in elderly people. However, no considerable treatments are available for the neuroprotection of NAION. The purpose of this study was to detect the effects of intravitreal injection of quercetin (Qcn) in a rodent model of anterior ischemic optic neuropathy (rAION). Methods: The rAION model was established using verteporfin and laser in a photodynamic procedure on the optic discs (ON) of rats. The rats received intravitreal injection of Qcn 2 days before the injury and once/week for 4 weeks after the infarct on optic neuropathy. Flash-visual evoked potential (VEP) were recorded to assess the visual function. TUNEL and retrograde Fluorogold labeling assessed the apoptosis and density of retinal ganglion cells (RGCs). ED-1 and Iba-1 staining of the optic nerves displayed the inflammatory response. Results: At 14 days post-infarct, Qcn treatment significantly reduced the number of apoptotic RGCs, as well as, ED1/Iba-1-positive cells/high power field(HPF) in the ON (p<0.01) as compared to the rAION group. At week 4 after rAION, 28.4% VEP amplitudes were estimated in the treated eyes of the fellow eyes in the rAION group and 64.7% in the rAION+Qcn group (p<0.01). In addition, Qcn saved the RGCs in the central retinas as compared to those of the rAION group (1967.5±162.1 and 2868±325.3 mm2, respectively (p<0.01), and the corresponding densities were 1654.8±104.8 and 2208±272.9 mm2 in the mid-peripheral retinas, respectively (p<0.01). Conclusion: The intravitreal injection of Qcn could protect the RGCs from injury in the rAION animal model, as demonstrated anatomically by RGC density and functionally by F-VEP. Moreover, Qcn might exert an anti-apoptosis role in the survival of RGCs and anti-inflammatory in the optic nerves.


Antioxidants ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1538
Author(s):  
Berta Sanz-Morello ◽  
Hamid Ahmadi ◽  
Rupali Vohra ◽  
Sarkis Saruhanian ◽  
Kristine Karla Freude ◽  
...  

Increasing evidence indicates that changes in the redox system may contribute to the pathogenesis of multiple optic neuropathies. Optic neuropathies are characterized by the neurodegeneration of the inner-most retinal neurons, the retinal ganglion cells (RGCs), and their axons, which form the optic nerve. Often, optic neuropathies are asymptomatic until advanced stages, when visual impairment or blindness is unavoidable despite existing treatments. In this review, we describe systemic and, whenever possible, ocular redox dysregulations observed in patients with glaucoma, ischemic optic neuropathy, optic neuritis, hereditary optic neuropathies (i.e., Leber’s hereditary optic neuropathy and autosomal dominant optic atrophy), nutritional and toxic optic neuropathies, and optic disc drusen. We discuss aspects related to anti/oxidative stress biomarkers that need further investigation and features related to study design that should be optimized to generate more valuable and comparable results. Understanding the role of oxidative stress in optic neuropathies can serve to develop therapeutic strategies directed at the redox system to arrest the neurodegenerative processes in the retina and RGCs and ultimately prevent vision loss.


2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 33S-37S ◽  
Author(s):  
Stéphane Hans ◽  
Lise Crevier-Buchman ◽  
Marta Circiu ◽  
Younes Chekkoury Idrissi ◽  
Léa Distinguin ◽  
...  

Objective: To investigate the feasibility and the outcomes of transoral laser CO2 microsurgery (TLM) for resection of early-stage squamous cell carcinoma (SCC) of the vocal folds through several additional surgical procedures and tips improving the glottic exposure. Methods: Retrospective chart review of patients treated by TLM cordectomy in a single European University Hospital for early-stage vocal fold SCCs (Tis, T1a, T1b, and T2). The following TLM outcomes were studied regarding the tumor size (Tis and T1a vs T1b and T2) and the margin status (negative vs positive/suspicious): patient position; type of laryngoscope; requirement to external counter pressure; resection of supraglottic structures (eg, ventricular band, epiglottic petiole, and suprahyoid epiglottis); pre- and postoperative complications; overall survival; disease-specific survival (DSS); and disease-free survival (DFS). Results: A total of 148 patients were included. The TLM was realized in 95.3% of cases. External counter pressure, partial, or total vestibulectomy were necessary in 65.9%, 57.4%, and 4.2% of cases, respectively. A resection of the epiglottic petiole was required in 24.8% of cases. The realization of both epiglottis petiole resection and vestibulectomies were significantly higher in patients with T2 and T1b SCCs compared to those with T1a and Tis SCCs ( P = .01). Different procedure tips were described for improving the laryngeal exposition. The 5-year laryngeal preservation rate, DSS, and DFS were significantly better in patients without SCC involvement of the anterior commissure, and did not vary according to the margin status. The laryngeal exposure difficulties did not impact the margin status. Conclusion: The exposure of glottis is possible in 95% of cases of early-stage vocal cord SCC but requires the use of several additional surgical procedures, especially for anterior commissure SCCs. The SCC involvement of the vocal fold anterior commissure is associated with lower DSS, DFS, and laryngeal preservation rate.


2013 ◽  
Vol 17 (4) ◽  
pp. 233-242 ◽  
Author(s):  
Catherine C. McCuaig ◽  
Lynn Cohen ◽  
Julie Powell ◽  
Afshin Hatami ◽  
Danielle Marcoux ◽  
...  

Background: Cutaneous ulceration is the most common complication of infantile hemangiomas (IHs) seen in a pediatric dermatology practice. Objective: The most effective treatments in our experience are compared to those in the current literature. Methods: The study was a retrospective chart review of therapy of 169 ulcerated IHs at a tertiary care pediatric hospital and a literature review. Results: Combination therapy was the rule. Local wound care was required in all, pain management in 72%, pulsed dye laser in 42%, infection control in 38%, diminution of the hemangioma through systemic therapy in 36%, and suppression of bleeding in 2%. Limitations: A retrospective review compared to a case-control study has inherent bias. In addition, our cases were all at a tertiary referral center. Conclusion: All ulcerated IHs benefit from local barrier creams or dressings. Pulsed dye laser, antibiotics, topical morphine 0.1% in hydrogel, topical becaplermin, and, most importantly, systemic therapy (especially propranolol) to reduce the hemangioma may be useful.


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