title: Optic neuropathy after vitrectomy for retinal detachment: clinical features and analysis of risk factors.
abstract: OBJECTIVE
  To describe the clinical characteristics of and risk factors for the development of optic neuropathy after pars plana vitrectomy (PPV) for macula-sparing primary rhegmatogenous retinal detachment (RRD) repair.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Seven patients who underwent PPV for macula-sparing primary RRD with subsequent development of optic neuropathy and 42 age- and gender-matched control patients undergoing PPV for macula-sparing primary RRD.
  
  
  METHODS
  Retrospective chart review of medical and surgical records.
  
  
  METHODS
  Clinical features of patients who developed optic neuropathy after PPV for macula-sparing RRD and analysis of potential risk factors (age, gender, medical history, surgical technique, intraoperative ocular perfusion pressure [OPP], and operative time).
  
  
  RESULTS
  At last follow-up, all 7 patients with optic neuropathy had visual acuity less than 20/200, relative afferent pupillary defects, optic nerve pallor, and visual field defects. A total of 5 of 7 patients (71%) demonstrated intraoperative reduced OPP with associated systemic hypotension compared with 7 of 42 patients (17%) in the control cohort (P = 0.01).
  
  
  CONCLUSIONS
  Optic neuropathy after PPV for macula-sparing primary RRD is a rare but potentially devastating complication. Although the cause is often unclear, reduced ocular perfusion due to intraoperative systemic hypotension may be a contributing risk factor in some eyes.
authors: The Retina Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors: Alok S
authors: AS
authors: Bansal
authors: Jason
authors: J
authors: Hsu
authors: Sunir J
authors: SJ
authors: Garg
authors: Arunan
authors: A
authors: Sivalingam
authors: James F
authors: JF
authors: Vander
authors: Mark
authors: M
authors: Moster
authors: Joseph I
authors: JI
authors: Maguire
authors: Carl D
authors: CD
authors: Regillo
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D058450:Endotamponade; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000175:diagnosis / Q000209:etiology; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology*; D011183:Postoperative Complications; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields; D014821:Vitrectomy