title: Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report.
abstract: Herein, we report a case of nonarteritic anterior ischemic optic neuropathy (NAION) following uneventful pars plana vitrectomy for macular hole treatment. A 56-year-old previously healthy woman presented with a full-thickness macular hole in right eye (OD) and small cup-to-disc ratios in both eyes. Five days after surgery, she noticed sudden painless loss of vision in OD and was found to have an afferent pupillary defect and intraocular pressure of 29 mmHg. Fundus examination showed right optic disc edema and the resolution of a macular hole with an inferior altitudinal visual field defect. Erythrocyte sedimentation rate, C-reactive protein levels, and general physical examination findings were normal. She was treated with hypotensive eyedrops and oral prednisone, resulting in mild visual improvement and a pale optic disc. A combination of face-down position and increased intraocular pressure due to a small optic disc cup were considered as potential mechanisms underlying NAION in the present case. Vitreoretinal surgeons should be aware of NAION as a potentially serious complication and be able to recognize associated risk factors and clinical findings.
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.|Hospital de Olhos Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Leonardo Provetti
authors.initials: LP
authors.lastname: Cunha
authors.affiliation: Hospital de Olhos Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Luciana Virgínia Ferreira Costa
authors.initials: LV
authors.lastname: Cunha
authors.affiliation: Hospital de Olhos Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Carolina Ferreira
authors.initials: CF
authors.lastname: Costa
authors.affiliation: Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Mário Luiz Ribeiro
authors.initials: ML
authors.lastname: Monteiro
mesh_terms: D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D011183:Postoperative Complications / Q000209:etiology; D012167:Retinal Perforations / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014794:Visual Fields; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods*