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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Format: | Article |
Language: | English |
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BMC
2018-01-01
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Series: | Journal of Medical Case Reports |
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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. |
first_indexed | 2024-12-21T13:19:09Z |
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id | doaj.art-46f557056c854928b8f70bb9e8846f30 |
institution | Directory Open Access Journal |
issn | 1752-1947 |
language | English |
last_indexed | 2024-12-21T13:19:09Z |
publishDate | 2018-01-01 |
publisher | BMC |
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series | Journal of Medical Case Reports |
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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