Alexandrakis G, Lam B L
Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33136, USA.
Am J Ophthalmol. 1999 Mar;127(3):354-5. doi: 10.1016/s0002-9394(98)00343-2.
To report the association between bilateral posterior ischemic optic neuropathy and spinal surgery.
Case report.
After prone-position spinal surgery of 8 hours' duration, a 68-year-old woman was completely blind in both eyes. Moderate periorbital edema and temporal conjunctival chemosis were present bilaterally. Ophthalmic examination disclosed normal-appearing optic nerve heads, except for bilateral nasal fullness related to bilateral optic nerve drusen, and no retinal edema. Immediate cerebral arteriography, magnetic resonance imaging, and electroretinography were normal. Visual-evoked response was not detectable, and 7 weeks later, severe bilateral optic nerve head pallor developed.
Severe selective hypoperfusion of the retrobulbar optic nerves may occur after spinal surgery. Pressure to the periorbital region may be a contributing factor.
报告双侧后部缺血性视神经病变与脊柱手术之间的关联。
病例报告。
一名68岁女性在持续8小时的俯卧位脊柱手术后双眼完全失明。双眼均出现中度眶周水肿和颞侧结膜水肿。眼科检查显示视神经乳头外观正常，但双侧与双侧视神经小疣相关的鼻侧饱满，且无视网膜水肿。即时脑动脉造影、磁共振成像和视网膜电图均正常。视觉诱发电位无法检测到，7周后出现严重的双侧视神经乳头苍白。
脊柱手术后可能发生球后视神经严重选择性低灌注。眶周区域受压可能是一个促成因素。
