Perioperative optic neuropathy in patients undergoing off‑pump coronary artery bypass graft surgery.
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Date
2014-04
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Abstract
Aims and Objectives: Perioperative optic neuropathy (PON) is a rare, but devastating complication following
coronary artery bypass graft surgery (CABG). We performed a retrospective study of PON associated
with off‑pump CABG (OPCABG) to identify possible risk factors. Materials and Methods: 1442 patients
underwent OPCABG over a 10‑month period from October 2008 to August 2009; PON was identified in
four (0.28%) patients. A retrospective review of the charts was done to identify the patient characteristics,
pre‑operative status, intra‑operative details, and ophthalmic examination details. Friedman test was used to
compare the hematocrit (Hct) and the mean arterial pressure (MAP) values across the three time periods:
Pre‑, intra‑ and post‑operative periods. Results: All four patients were male, diabetic, and in the age range
51‑69 years. All patients noted unilateral or bilateral severe visual loss in the immediate post‑operative period,
which was permanent. All the four patients had statistically significant decrease in the Hct (P < 0.039) and
mean arterial blood pressure (P < 0.018) in the intraoperative and post‑operative period when compared to
pre‑operative value. Conclusions: PON is a rare but definite possibility in patients undergoing OPCABG.
Diabetes mellitus may be a risk factor. Perioperative hemodynamic abnormalities like decrease in MAP and
anemia may play a role in the development of PON in OPCABG.
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Keywords
Coronary artery bypass grafting, Diabetes mellitus, Optic neuropathy
Citation
Battu Rajani, Prasad Apoorva, Kanchi Muralidhar. Perioperative optic neuropathy in patients undergoing off‑pump coronary artery bypass graft surgery. Annals of Cardiac Anaesthesia. 2014 Apr; 17(1): 92-97.