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Optic neuropathy after vitrectomy for retinal detachment: clinical features and analysis of risk factors.

Abstract：

PURPOSE:To describe the clinical characteristics of and risk factors for the development of optic neuropathy after pars plana vitrectomy (PPV) for macula-sparing primary rhegmatogenous retinal detachment (RRD) repair. DESIGN:Retrospective case-control study. PARTICIPANTS:Seven patients who underwent PPV for macula-sparing primary RRD with subsequent development of optic neuropathy and 42 age- and gender-matched control patients undergoing PPV for macula-sparing primary RRD. METHODS:Retrospective chart review of medical and surgical records. MAIN OUTCOME MEASURES:Clinical features of patients who developed optic neuropathy after PPV for macula-sparing RRD and analysis of potential risk factors (age, gender, medical history, surgical technique, intraoperative ocular perfusion pressure [OPP], and operative time). RESULTS:At last follow-up, all 7 patients with optic neuropathy had visual acuity less than 20/200, relative afferent pupillary defects, optic nerve pallor, and visual field defects. A total of 5 of 7 patients (71%) demonstrated intraoperative reduced OPP with associated systemic hypotension compared with 7 of 42 patients (17%) in the control cohort (P = 0.01). CONCLUSIONS:Optic neuropathy after PPV for macula-sparing primary RRD is a rare but potentially devastating complication. Although the cause is often unclear, reduced ocular perfusion due to intraoperative systemic hypotension may be a contributing risk factor in some eyes.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Bansal AS,Hsu J,Garg SJ,Sivalingam A,Vander JF,Moster M,Maguire JI,Regillo CD

doi

10.1016/j.ophtha.2012.06.002

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

2364-70

issue

11

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(12)00510-6

journal_volume

119

pub_type

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