Farukhi Ahmed Sarah, Tai Audrey Xi, Schmutz Mason, Combs John, Mosaed Sameh
Gavin Herbert Eye Institute and University of California, Irvine School of Medicine, Irvine, CA, USA.
Case Rep Ophthalmol. 2017 Apr 3;8(1):200-207. doi: 10.1159/000468143. eCollection 2017 Jan-Apr.
The purpose of this case report is to evaluate risk factors associated with post-coronary artery bypass graft (CABG) ocular hypotony compared to post-CABG ischemic optic neuropathy.
The patient described here is a single case at the University of California, Irvine Medical Center, from July 2016. This case demonstrates the rare incidence of acute post-CABG ocular hypotony and vision loss in a patient with prior history of optic atrophy. Both vision loss and hypotony resolved completely to baseline without intervention within 3 days postoperatively.
Severe anemia and large fluctuations in central venous pressure and blood pressure can occur in any patient undergoing CABG surgery. These hemodynamic shifts can cause transient ischemia to pressure controlling systems such as the ciliary body and reduce episcleral venous pressure. Other risk factors for acute hypotony in the setting of CABG surgery also include the use of hypertonic agents, cardiopulmonary bypass, and intravenous anesthesia.
本病例报告的目的是评估冠状动脉旁路移植术(CABG)后低眼压与CABG后缺血性视神经病变相关的危险因素。
此处描述的患者是2016年7月在加利福尼亚大学欧文医学中心的单一病例。该病例显示了既往有视神经萎缩病史的患者术后急性CABG后低眼压和视力丧失的罕见发生率。视力丧失和低眼压在术后3天内未经干预完全恢复至基线水平。
任何接受CABG手术的患者都可能发生严重贫血以及中心静脉压和血压的大幅波动。这些血流动力学变化可导致对诸如睫状体等压力控制系统的短暂缺血,并降低巩膜静脉压。CABG手术中急性低眼压的其他危险因素还包括使用高渗药物、体外循环和静脉麻醉。