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Posterior ischemic optic neuropathy after hemodialysis
Lawrence M Buono1, Rod Foroozan, Peter J Savino
1Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania, USA.
Ophthalmology
|June 12, 2003
Summary
This case report details a rare instance of vision loss from posterior ischemic optic neuropathy (PION) following hemodialysis. This complication, linked to anemia and hypotension, typically presents as anterior ischemic optic neuropathy.
Area of Science:
- Ophthalmology
- Neurology
- Nephrology
Background:
- Hemodialysis is a life-sustaining treatment for end-stage renal disease.
- Visual complications, though rare, can occur during or after hemodialysis.
- Anterior ischemic optic neuropathy is a more common cause of visual loss post-hemodialysis.
Observation:
- A patient experienced sudden, painless, bilateral vision loss with no light perception post-hemodialysis.
- Funduscopic examination was normal, but pupillary response to light was absent.
- Neuro-imaging revealed white matter changes, while electrophysiologic testing showed unrecordable visually evoked responses.
Findings:
- The patient was diagnosed with posterior ischemic optic neuropathy (PION), a rare cause of visual impairment after hemodialysis.
- The visual loss was associated with anemia and hypotensive episodes during the procedure.
- This represents a unique case, as PION is not previously documented as a complication of hemodialysis.
Implications:
- Highlights the potential for PION as a rare complication of hemodialysis.
- Emphasizes the need for vigilance regarding visual changes in patients undergoing hemodialysis.
- Suggests further research into the mechanisms linking hemodialysis, hypotension, anemia, and ischemic optic neuropathies.