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Related Experiment Videos

Visual loss after coronary artery bypass surgery

M L Moster1

  • 1Department of Neurosensory Sciences, Albert Einstein Medical Center, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.

Survey of Ophthalmology
|April 21, 1998
PubMed
Summary

A 70-year-old man developed nonarteritic anterior ischemic optic neuropathy after coronary artery bypass graft surgery. Predisposing factors included hypotension, anemia, and carotid artery stenosis, not giant cell arteritis despite elevated ESR.

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Area of Science:

  • Ophthalmology
  • Cardiovascular Surgery
  • Neurology

Background:

  • Coronary artery bypass graft (CABG) surgery is a major cardiovascular procedure.
  • Postoperative complications can affect various organ systems, including vision.
  • Ischemic optic neuropathies are a significant cause of vision loss.

Observation:

  • A 70-year-old male patient experienced sudden visual loss following CABG.
  • The clinical presentation was diagnosed as nonarteritic anterior ischemic optic neuropathy (NAION).
  • The patient had several potential predisposing factors for NAION.

Findings:

  • Identified predisposing factors included hypotension, anemia, a "disk at risk" (optic disc morphology), and internal carotid artery stenosis.
  • The erythrocyte sedimentation rate (ESR) was elevated postoperatively.

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  • Elevated ESR alone is not indicative of giant cell arteritis in this context.

    • Implications:

    • Understanding predisposing factors for NAION is crucial for risk assessment in surgical patients.
    • Distinguishing NAION from other optic neuropathies, like giant cell arteritis, is vital for appropriate management.
    • This case highlights the importance of considering multifactorial causes of visual loss after cardiac surgery.