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

Department of Clinical Medicine

1 Citation (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.

Original language	English
Journal	BMJ Case Reports
Volume	2014
ISSN	1757-790X
DOIs	https://doi.org/10.1136/bcr-2013-201173
Publication status	Published - 6 Jan 2014

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

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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.",

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

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

language = "English",

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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

Keywords

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