title: Anterior ischemic optical neuropathy in children on chronic peritoneal dialysis: report of 7 cases.
abstract: BACKGROUND
  Anterior ischemic optic neuropathy (AION) is characterized by infarction of the optic nerve head due to hypoperfusion of the posterior ciliary arteries and causes sudden blindness in adults on chronic dialysis, but has rarely been described in children. Unlike adults, children do not have comorbidities related to aging.
  
  
  METHODS
  We retrospectively analyzed data of 7 children on nocturnal continuous cycling peritoneal dialysis (CCPD) who developed AION identified within the Italian Registry of Pediatric Chronic Dialysis. We also summarized data from 10 cases reported in the literature.
  
  
  RESULTS
  Our 7 patients suffered from acute onset bilateral blindness. Their mean age was 3.2 years and chronic hypotension had been observed prior the AION in 3 of the 7 children. Low systolic blood pressure (SBP) was associated with higher risk of developing AION according to statistical analysis. None recovered completely. In total, 11 out of 16 experienced a partial recovery and no clear evidence emerged favoring specific treatments.
  
  
  CONCLUSIONS
  Hypotensive children treated with CCPD are at increased risk of developing AION, which often results in irreversible blindness.
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Zazzo
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Guzzo
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: De Galasso
authors.affiliation: Department of Ophthalmology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Fortunato
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Leozappa
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, Regina Margherita University Hospital, Turin, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Peruzzi
authors.affiliation: Department of Pediatrics, Pediatric Nephrology, Dialysis and Transplantation Unit, University of Padua, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vidal
authors.affiliation: Pediatric Nephrology Unit, G. Di Cristina Children's Hospital, Palermo, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Corrado
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, Giannina Gaslini Institute, Genoa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Picca
authors.affiliation: Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Emma
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis* / Q000209:etiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies
keywords: AION; anterior ischemic optic neuropathy; dehydration; hypotension; peritoneal dialysis; sudden blindness; young children