Anterior ischaemic optic neuropathy after coronary artery bypass graft: the role of anaemia in diabetics.
OBJECTIVE
To ascertain factors associated with anterior ischaemic optic neuropathy (AION) following coronary artery bypass graft (CABG) in a Lebanese population.


METHODS
A retrospective chart review of consecutive CABG performed over a 5-year period (1995-1999) in one medical centre. A comparison of clinical characteristics was carried out between AION cases and subjects free from AION. The variables analysed included history of diabetes as well as preoperative, intraoperative, or postoperative values of haematocrit, blood sugar, oxygen saturation, and arterial blood pressure.


RESULTS
A total of 1,594 persons were included. Three subjects experienced acute visual loss from AION following CABG, all had diabetes mellitus, and two suffered from severe postoperative anaemia. Among diabetics (n=484), the risk of AION was significantly higher in subjects with postoperative haematocrit falling below 22 (28.6%) than the rest (0.21%) (P=0.001). Blood transfusion was given in two subjects with prompt visual recovery.


CONCLUSIONS
Severe anaemia in patients undergoing CABG appears to be a risk factor for AION, especially in diabetics, and needs prompt correction to prevent or reverse the ischaemic ocular events.
Mansour
A M
AM
Department of Ophthalmology, American University of Beirut, POB 113-6044, Beirut, Lebanon. dr.ahmad@cyberia.net.lb
Awwad
S T
ST
Najjar
D M
DM
Sibai
A N
AN
Sibai
A M
AM
Medawar
W A
WA
Hamade
I H
IH
Haddad
R S
RS
Kassak
K M
KM
Obeid
M Y
MY
D000368:Aged; D000740:Anemia / Q000150:complications* / Q000628:therapy; D001803:Blood Transfusion; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications* / Q000601:surgery; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors