BACKGROUND: Sudden blindness caused by anterior ischemic optic neuropathy (AION) is a rare complication for patients undergoing peritoneal dialysis (PD). Prognosis is generally poor, with AION commonly resulting in permanent visual loss. METHODS: We first describe four case reports of children with AION during PD treatment. We then review ten additional AION cases reported in the literature and compare these 14 affected patients with a control cohort of 59 non-affected patients in the Vienna PD registry. RESULTS: Significant risk factors for AION were identified as median age (4 vs. 27 months; p < 0.001), autosomal recessive polycystic kidney disease (28.6 vs. 3.4%; p = 0.01), anephric status (53.8 vs. 6.8%; p < 0.001) and low to normal blood pressure evidenced by the number of patients having to be treated with antihypertensive medications (14.3 vs. 62.7%; p = 0.01). Severe hypovolemia was reported in 50% of all cases. Outcome was visual loss with optic atrophy in nine patients; five patients had a good visual outcome. The major difference in treatment was a rapid bolus of saline within 12 h after the initial symptoms. CONCLUSIONS: Young age, autosomal recessive polycystic kidney disease, anephric status and hypotension are substantial risk factors for AION. Early hospitalization with vascular refilling within a few hours following onset of blindness leads to improved visual outcome.
BACKGROUND:Sudden blindness caused by anterior ischemic optic neuropathy (AION) is a rare complication for patients undergoing peritoneal dialysis (PD). Prognosis is generally poor, with AION commonly resulting in permanent visual loss. METHODS: We first describe four case reports of children with AION during PD treatment. We then review ten additional AION cases reported in the literature and compare these 14 affected patients with a control cohort of 59 non-affected patients in the Vienna PD registry. RESULTS: Significant risk factors for AION were identified as median age (4 vs. 27 months; p < 0.001), autosomal recessive polycystic kidney disease (28.6 vs. 3.4%; p = 0.01), anephric status (53.8 vs. 6.8%; p < 0.001) and low to normal blood pressure evidenced by the number of patients having to be treated with antihypertensive medications (14.3 vs. 62.7%; p = 0.01). Severe hypovolemia was reported in 50% of all cases. Outcome was visual loss with optic atrophy in nine patients; five patients had a good visual outcome. The major difference in treatment was a rapid bolus of saline within 12 h after the initial symptoms. CONCLUSIONS: Young age, autosomal recessive polycystic kidney disease, anephric status and hypotension are substantial risk factors for AION. Early hospitalization with vascular refilling within a few hours following onset of blindness leads to improved visual outcome.
Authors: Abdullah Al-Kaabi; Agha S Haider; Mohammed O Shafeeq; Mohammed A El-Naggari; Ibtisam El-Nour; Anuradha Ganesh Journal: Sultan Qaboos Univ Med J Date: 2016-11-30
Authors: Kathrin Burgmaier; Gema Ariceta; Martin Bald; Anja Katrin Buescher; Mathias Burgmaier; Florian Erger; Michaela Gessner; Ibrahim Gokce; Jens König; Claudia Kowalewska; Laura Massella; Antonio Mastrangelo; Djalila Mekahli; Lars Pape; Ludwig Patzer; Alexandra Potemkina; Gesa Schalk; Raphael Schild; Rukshana Shroff; Maria Szczepanska; Katarzyna Taranta-Janusz; Marcin Tkaczyk; Lutz Thorsten Weber; Elke Wühl; Donald Wurm; Simone Wygoda; Ilona Zagozdzon; Jörg Dötsch; Jun Oh; Franz Schaefer; Max Christoph Liebau Journal: Sci Rep Date: 2020-09-29 Impact factor: 4.379