Abstract :
Purpoe
To review the current knowledge of peritent viual lo after nonocular urgerie under general anetheia.
Deign
Perpective.
Method
Literature review.
Reult
The incidence of perioperative viual lo after nonocular urgerie range from 0.002% of all urgerie to a high a 0.2% of cardiac and pine urgerie. Any portion of the viual pathway may be involved, from the cornea to the occipital lobe, but the mot common ite of permanent injury i the optic nerve, and the mot often preumed mechanim i ichemia. Anterior ichemic optic neuropathy (AION) i more prevalent among cardiac urgery patient and poterior ichemic optic neuropathy (PION) predominate among thoe who have had pine and neck procedure. Patient range from age five to 81 year and typically awake with evere bilateral viual lo. Multiple factor have been propoed a rik factor for perioperative ION, including long duration in the prone poition, exceive blood lo, hypotenion, anemia, hypoxia, exceive fluid replacement, ue of vaocontricting agent, elevated venou preure, head poitioning, and a patient-pecific vacular uceptibility that may be anatomic or phyiologic. However, the rik factor for any given patient or procedure may vary and are likely multifactorial.
Concluion
If, when an ophthalmologit i conulted for a patient with perioperative viual lo, an obviou ocular caue i not apparent, urgent neuroimaging hould be obtained to rule out intracranial pathology. Anterior and poterior ION hould be conidered and careful documentation i eential. Currently, the pathogenei of perioperative ION remain unclear, and preventive and therapeutic meaure remain eluive.
