Holy Sarah E, Tsai Jonathan H, McAllister Russell K, Smith Kyle H
Department of Ophthalmology, Scott and White Memorial Hospital and Clinic, Temple, Texas 76504-7115, USA.
Anesthesiology. 2009 Feb;110(2):246-53. doi: 10.1097/ALN.0b013e318194b238.
Ischemic optic neuropathy is the most common cause of perioperative vision loss. The authors sought to determine its incidence and identify risk factors that may contribute to perioperative ischemic optic neuropathy associated with nonophthalmologic surgical procedures at their institution.
Seventeen patients who experienced perioperative ischemic optic neuropathy were included in a retrospective chart review case-control study. The authors matched each patient with two control patients who had a similar surgical procedure but did not lose vision. They analyzed multiple perioperative variables for the case and control groups.
From among 126,666 surgical procedures performed during the study period, the authors identified 17 patients with perioperative ischemic optic neuropathy, yielding an overall incidence of 0.013%. There were no hemodynamic variables that differed significantly between the ischemic optic neuropathy patients and the matched control patients.
The authors conclude that perioperative ischemic optic neuropathy can occur in the absence of atypical fluctuations in hemodynamic variables during the perioperative period.
缺血性视神经病变是围手术期视力丧失的最常见原因。作者试图确定其发病率,并识别在其机构中与非眼科手术相关的围手术期缺血性视神经病变的危险因素。
17例经历围手术期缺血性视神经病变的患者纳入一项回顾性病历审查病例对照研究。作者为每位患者匹配两名接受类似手术但未失明的对照患者。他们分析了病例组和对照组的多个围手术期变量。
在研究期间进行的126,666例手术中,作者识别出17例围手术期缺血性视神经病变患者,总体发病率为0.013%。缺血性视神经病变患者与匹配的对照患者之间没有显著差异的血流动力学变量。
作者得出结论,围手术期缺血性视神经病变可在围手术期血流动力学变量无异常波动的情况下发生。