Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report

Abstract Background The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors...

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Main Authors: A. Niro, G. Sborgia, A. Sborgia, G. Alessio
Format: Article
Language:English
Published: BMC 2018-01-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13256-017-1539-1
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author A. Niro
G. Sborgia
A. Sborgia
G. Alessio
author_facet A. Niro
G. Sborgia
A. Sborgia
G. Alessio
author_sort A. Niro
collection DOAJ
description Abstract Background The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors could underlie anterior ischemic optic neuropathy. In this case, we report a rare presentation of a bilateral anterior ischemic optic neuropathy after coronary artery bypass graft and speculate on the preoperative hyperhomocysteinemia as an independent risk factor for anterior ischemic optic neuropathy. Case presentation A 56-year-old white man, a tobacco smoker with type 2 diabetes and coronary artery disease, underwent a conventional coronary artery bypass graft with extracorporeal circulation. In spite of ongoing anti-aggregation, antithrombotic, and vasodilator therapy, 10 days after the surgery he complained of severe bilateral visual loss. Funduscopy and fluorescein angiography revealed a bilateral anterior ischemic optic neuropathy. Analysis of preoperative laboratory tests revealed hyperhomocysteinemia. Conclusion Hyperhomocysteinemia could increase the risk of ocular vascular damage and bilateral ocular involvement in patients who have undergone conventional coronary artery bypass graft.
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spelling doaj.art-46f557056c854928b8f70bb9e8846f302022-12-21T19:02:37ZengBMCJournal of Medical Case Reports1752-19472018-01-011211410.1186/s13256-017-1539-1Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case reportA. Niro0G. Sborgia1A. Sborgia2G. Alessio3Department of Medical Sciences, Neuroscience and Sense Organs,, University of Bari “A. Moro”, Eye ClinicDepartment of Medical Sciences, Neuroscience and Sense Organs,, University of Bari “A. Moro”, Eye ClinicDepartment of Medical Sciences, Neuroscience and Sense Organs,, University of Bari “A. Moro”, Eye ClinicDepartment of Medical Sciences, Neuroscience and Sense Organs,, University of Bari “A. Moro”, Eye ClinicAbstract Background The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors could underlie anterior ischemic optic neuropathy. In this case, we report a rare presentation of a bilateral anterior ischemic optic neuropathy after coronary artery bypass graft and speculate on the preoperative hyperhomocysteinemia as an independent risk factor for anterior ischemic optic neuropathy. Case presentation A 56-year-old white man, a tobacco smoker with type 2 diabetes and coronary artery disease, underwent a conventional coronary artery bypass graft with extracorporeal circulation. In spite of ongoing anti-aggregation, antithrombotic, and vasodilator therapy, 10 days after the surgery he complained of severe bilateral visual loss. Funduscopy and fluorescein angiography revealed a bilateral anterior ischemic optic neuropathy. Analysis of preoperative laboratory tests revealed hyperhomocysteinemia. Conclusion Hyperhomocysteinemia could increase the risk of ocular vascular damage and bilateral ocular involvement in patients who have undergone conventional coronary artery bypass graft.http://link.springer.com/article/10.1186/s13256-017-1539-1HyperhomocysteinemiaAnterior ischemic optic neuropathyConventional coronary artery bypass graft (CCABG)
spellingShingle A. Niro
G. Sborgia
A. Sborgia
G. Alessio
Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
Journal of Medical Case Reports
Hyperhomocysteinemia
Anterior ischemic optic neuropathy
Conventional coronary artery bypass graft (CCABG)
title Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
title_full Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
title_fullStr Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
title_full_unstemmed Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
title_short Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report
title_sort hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft a case report
topic Hyperhomocysteinemia
Anterior ischemic optic neuropathy
Conventional coronary artery bypass graft (CCABG)
url http://link.springer.com/article/10.1186/s13256-017-1539-1
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AT asborgia hyperhomocysteinemiainbilateralanteriorischemicopticneuropathyafterconventionalcoronaryarterybypassgraftacasereport
AT galessio hyperhomocysteinemiainbilateralanteriorischemicopticneuropathyafterconventionalcoronaryarterybypassgraftacasereport