Habib Ahmed M, Fouad Yousef A, Mekkawy Mahmood O
Al Mashreq Eye Center, Cairo, Egypt.
Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt.
Case Rep Ophthalmol Med. 2021 Jun 7;2021:9952500. doi: 10.1155/2021/9952500. eCollection 2021.
Ischemic optic neuropathy (ION) resulting in perioperative vision loss (POVL) is a rare occurrence following nonocular procedures. Bilateral simultaneous anterior ION (AION) is even rarer, and no cases have been reported after central neuraxial block. We report a case of bilateral simultaneous AION, confirmed by multimodal imaging, in a 66-year-old male patient who underwent total knee arthroplasty under epidural anesthesia in which episodes of hypotension-one intraoperatively and one late postoperatively-had occurred. Hypotension is the most common adverse effect to epidural block, and counseling about POVL should extend beyond general anesthesia to include those undergoing procedures with central neuraxial block.
缺血性视神经病变（ION）导致围手术期视力丧失（POVL）在非眼科手术中是一种罕见的情况。双侧同时性前部缺血性视神经病变（AION）更为罕见，且尚无在中枢神经轴索阻滞术后发生此类情况的报道。我们报告一例66岁男性患者，在硬膜外麻醉下行全膝关节置换术，术中及术后晚期各发生一次低血压，经多模态成像确诊为双侧同时性AION。低血压是硬膜外阻滞最常见的不良反应，关于POVL的咨询应不仅限于全身麻醉，还应包括接受中枢神经轴索阻滞手术的患者。
