Skip to main content

Advertisement

Log in

Nonarteritic anterior ischemic optic neuropathy and ‘visual field defects’ following vitrectomy: could they be related?

  • Short Communication
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Visual field defects after uncomplicated vitrectomy have been reported but poorly explained. We describe two cases of nonarteritic anterior ischemic optic neuropathy (NAION) observed following vitrectomy. We also reviewed the literature for cases of post-vitrectomy visual field defects for evidence of optic nerve damage.

Methods

Two patients developed optic disc edema and features of an optic neuropathy after uncomplicated vitrectomy for macular hole and epiretinal membrane. A systematic literature search was conducted to obtain prior reports of visual field defects or ischemic optic neuropathy following vitrectomy. Additional studies were identified from the bibliographies of the retrieved articles.

Results

The incidence of visual field defects following vitrectomy has varied from 1–71% across all studies. Overall, we found 160 (14.5%) cases of unexplained visual field defects following vitrectomy out of 1,104 patients. Of these, 31 eyes (19.4%) have shown some sign of optic nerve damage following vitrectomy, including pallor in 29 eyes, relative afferent pupillary defect in eight eyes, and intrapapillary hemorrhage in two eyes.

Conclusions

NAION may develop following vitrectomy. “Visual field defects” following vitrectomy are common and many of the involved eyes demonstrate evidence of optic nerve damage, some of which may have represented NAION.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Arima T, Uemura A, Otsuka S, Doi N, Nakao K (1998) Macular hole surgery-associated peripheral visual field loss. Jpn J Ophthalmol 42:476–483

    Article  PubMed  CAS  Google Scholar 

  2. Boldt HC, Munden PM, Folk JC, Mehaffey MG (1996) Visual field defects after macular hole surgery. Am J Ophthalmol 122:371–381

    PubMed  CAS  Google Scholar 

  3. Bopp S, Lucke K, Hille U (1997) Peripheral visual field loss after vitreous surgery for macular holes. Graefe Arch Clin Exp Ophthalmol 235:362–371

    Article  CAS  Google Scholar 

  4. Cullinane AB, Cleary PE (2000) Prevention of visual field defects after macular hole surgery. Br J Ophthalmol 84:372–377

    Article  PubMed  CAS  Google Scholar 

  5. Ezra E, Arden GB, Riordan-Eva P, Aylward GW, Gregor ZJ (1996) Visual field loss following vitrectomy for stage 2 and 3 macular holes. Br J Ophthalmol 80:519–525

    PubMed  CAS  Google Scholar 

  6. Gass CA, Haritoglou C, Messmer EM, Schaumberger M, Kampik A (2001) Peripheral visual field defects after macular hole surgery: a complication with decreasing incidence. Br J Ophthalmol 85:549–551

    Article  PubMed  CAS  Google Scholar 

  7. Haritoglou C, Gass CA, Schaumberger M, Gandorfer A, Ulbig MW, Kampik A (2002) Long-term follow-up after macular hole surgery with internal limiting membrane peeling. Am J Ophthalmol 134:661–666

    Article  PubMed  Google Scholar 

  8. Hirata A, Yonemura N, Hasumura T, Murata Y, Negi A (2000) Effect of infusion air pressure on visual field defects after macular hole surgery. Am J Ophthalmol 130:611–616

    Article  PubMed  CAS  Google Scholar 

  9. Hutton WL, Fuller DG, Snyder WB, Fellman RL, Swanson WH (1996) Visual field defects after macular hole surgery. A new finding. Ophthalmology 103:2152–2158

    PubMed  CAS  Google Scholar 

  10. Kerrison JB, Haller JA, Elman M, Miller NR (1996) Visual field loss following vitreous surgery. Arch Ophthalmol 114:564–569

    PubMed  CAS  Google Scholar 

  11. Kurok AM, Kitaoka T, Taniguchi H, Amemiya T (2002) Hyperbaric oxygen therapy reduces visual field defect after macular hole surgery. Ophthalmic Surg Lasers 33:200–206

    PubMed  Google Scholar 

  12. Lee MS, Rizzo JF 3rd, Lessell S (2002) Neuro-ophthalmologic complications of cataract surgery. Semin Ophthalmol 17:149–152

    PubMed  Google Scholar 

  13. McCulley TJ, Lam BL, Feuer WJ (2003) Nonarteritic anterior ischemic optic neuropathy and surgery of the anterior segment: temporal relationship analysis. Am J Ophthalmol 136:1171–1172

    Article  PubMed  Google Scholar 

  14. McDonald HR, Verre WP, Aaberg TM (1986) Surgical management of idiopathic epiretinal membranes. Ophthalmology 93:978–983

    PubMed  CAS  Google Scholar 

  15. Melberg NS, Thomas MA (1995) Visual field loss after pars plana vitrectomy with air/fluid exchange. Am J Ophthalmol 120:386–388

    PubMed  CAS  Google Scholar 

  16. Oh KT, Boldt HC, Maturi RK, Folk JC, Kardon RH (2000) Evaluation of patients with visual field defects following macular hole surgery using multifocal electroretinography. Retina 20:238–243

    Article  PubMed  CAS  Google Scholar 

  17. Ohji M, Nao-I N, Saito Y, Hayashi A, Tano Y (1999) Prevention of visual field defect after macular hole surgery by passing air used for fluid-air exchange through water. Am J Ophthalmol 127:62–66

    Article  PubMed  CAS  Google Scholar 

  18. Paques M, Massin P, Santiago PY, Spielmann AC, Gaudric A (1997) Visual field loss after vitrectomy for full-thickness macular holes. Am J Ophthalmol 124:88–94

    PubMed  CAS  Google Scholar 

  19. Pendergast SD, McCuen BW 2nd (1996) Visual field loss after macular hole surgery. Ophthalmology 103:1069–1077

    PubMed  CAS  Google Scholar 

  20. Russell SR, Hageman GS (2001) Optic disc, foveal, and extrafoveal damage due to surgical separation of the vitreous. Arch Ophthalmol 119:1653–1658

    PubMed  CAS  Google Scholar 

  21. Serrano LA, Behrens MM, Carroll FD (1982) Postcataract extraction ischemic optic neuropathy. Arch Ophthalmol 100:1177–1178

    PubMed  CAS  Google Scholar 

  22. Takenaka H, Maeno T, Mano T, Mitsuda H (1999) Causes of visual field defects after vitrectomy. Nippon Ganka Gakkai Zasshi 103:399–403

    PubMed  CAS  Google Scholar 

  23. Welch JC (1997) Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole. Am J Ophthalmol 124:698–699

    PubMed  CAS  Google Scholar 

  24. Williams JM Sr, Jacobson DM (1997) Visual field loss after vitreous surgery. Arch Ophthalmol 115:434–435

    PubMed  Google Scholar 

  25. Yan H, Dhurjon L, Chow DR, Williams D, Chen JC (1998) Visual field defect after pars plana vitrectomy. Ophthalmology 105:1612–1616

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael S. Lee.

Additional information

Grant Support: Supported in part by an nnrestricted grant from Research to Prevent Blindness, New York, NY (MSL).

Proprietary Interest: None.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taban, M., Lewis, H. & Lee, M.S. Nonarteritic anterior ischemic optic neuropathy and ‘visual field defects’ following vitrectomy: could they be related?. Graefe's Arch Clin Exp Ophthalmol 245, 600–605 (2007). https://doi.org/10.1007/s00417-006-0420-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-006-0420-5

Keywords

Navigation