Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

Christoffer Ostri; Nathalie Zibrandtsen; Michael Larsen; Steffen Hamann

doi:10.1136/bcr-2013-201173

Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

Christoffer Ostri, Nathalie Zibrandtsen, Michael Larsen, Steffen Hamann

Institut for Klinisk Medicin

1 Citationer (Scopus)

Abstract

We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG) and visual evoked potentials (VEP) testing. During 1 year of follow-up, repeated optical coherence tomography (OCT) scans demonstrated optic disc atrophy, which was interpreted as a sign of direct retrograde ganglion cell degeneration after ischaemic damage to the retrolaminar part of the optic nerves. The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools.

Originalsprog	Engelsk
Tidsskrift	BMJ Case Reports
Vol/bind	2014
ISSN	1757-790X
DOI	https://doi.org/10.1136/bcr-2013-201173
Status	Udgivet - 6 jan. 2014

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10.1136/bcr-2013-201173

Citationsformater

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title = "Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage",

abstract = "We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG) and visual evoked potentials (VEP) testing. During 1 year of follow-up, repeated optical coherence tomography (OCT) scans demonstrated optic disc atrophy, which was interpreted as a sign of direct retrograde ganglion cell degeneration after ischaemic damage to the retrolaminar part of the optic nerves. The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools.",

keywords = "Adult, Blindness, Diagnosis, Differential, Electroretinography, Evoked Potentials, Visual, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Hysterectomy, Magnetic Resonance Imaging, Optic Neuropathy, Ischemic, Postoperative Complications, Postpartum Hemorrhage, Tomography, Optical Coherence, Visual Field Tests",

author = "Christoffer Ostri and Nathalie Zibrandtsen and Michael Larsen and Steffen Hamann",

year = "2014",

month = jan,

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doi = "10.1136/bcr-2013-201173",

language = "English",

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TY - JOUR

T1 - Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

AU - Ostri, Christoffer

AU - Zibrandtsen, Nathalie

AU - Larsen, Michael

AU - Hamann, Steffen

PY - 2014/1/6

Y1 - 2014/1/6

N2 - We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG) and visual evoked potentials (VEP) testing. During 1 year of follow-up, repeated optical coherence tomography (OCT) scans demonstrated optic disc atrophy, which was interpreted as a sign of direct retrograde ganglion cell degeneration after ischaemic damage to the retrolaminar part of the optic nerves. The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools.

AB - We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG) and visual evoked potentials (VEP) testing. During 1 year of follow-up, repeated optical coherence tomography (OCT) scans demonstrated optic disc atrophy, which was interpreted as a sign of direct retrograde ganglion cell degeneration after ischaemic damage to the retrolaminar part of the optic nerves. The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools.

KW - Adult

KW - Blindness

KW - Diagnosis, Differential

KW - Electroretinography

KW - Evoked Potentials, Visual

KW - Female

KW - Fluorescein Angiography

KW - Follow-Up Studies

KW - Humans

KW - Hysterectomy

KW - Magnetic Resonance Imaging

KW - Optic Neuropathy, Ischemic

KW - Postoperative Complications

KW - Postpartum Hemorrhage

KW - Tomography, Optical Coherence

KW - Visual Field Tests

U2 - 10.1136/bcr-2013-201173

DO - 10.1136/bcr-2013-201173

M3 - Journal article

C2 - 24395872

SN - 1757-790X

VL - 2014

JO - BMJ Case Reports

JF - BMJ Case Reports

ER -

Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

Abstract

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