Posterior ischemic optic neuropathy: Perioperative risk factors

Area of Science:

• Ophthalmology
• Neurology
• Surgical Critical Care

Background:

• Perioperative posterior ischemic optic neuropathy (PION) is a rare, severe complication causing irreversible vision loss.
• It is frequently associated with spine, orthopedic, cardiac bypass, and neck dissection surgeries.
• Multifactorial etiology involves hypotension, anemia, hemodilution, edema, and abnormal autoregulation.

Purpose of the Study:

• To review current literature on perioperative PION.
• To investigate perioperative risk factors for PION.
• To enhance understanding of PION pathogenesis and identify high-risk patients.

Main Methods:

• Literature review of perioperative PION.
• Analysis of a study investigating perioperative risk factors.
• Corroboration of findings with existing evidence.

Main Results:

• PION is linked to spinal, cardiovascular, and abdominal surgeries, longer procedure durations, and facial edema.
• Anemia and chronic hypertension are identified as frequent risk factors.
• Findings support existing literature on PION triggers.

Conclusions:

• Identifying at-risk patients and implementing prophylactic measures are crucial for preventing PION.
• Optimizing hemoglobin, hemodynamic status, and tissue oxygenation are key preventive strategies.
• Treatment remains uncertain, focusing on immediate hemodynamic correction.