Giacomo Di Zazzo1, Isabella Guzzo1, Lara De Galasso1, Michele Fortunato2, Giovanna Leozappa1, Licia Peruzzi3, Enrico Vidal4, Ciro Corrado5, Enrico Verrina6, Stefano Picca1, Francesco Emma1. 1. Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy. 2. Department of Ophthalmology, Bambino Gesù Children's Hospital, Rome, Italy. 3. Nephrology, Dialysis and Transplantation Unit, Regina Margherita University Hospital, Turin, Italy. 4. Department of Pediatrics, Pediatric Nephrology, Dialysis and Transplantation Unit, University of Padua, Italy. 5. Pediatric Nephrology Unit, G. Di Cristina Children's Hospital, Palermo, Italy. 6. Nephrology, Dialysis and Transplantation Unit, Giannina Gaslini Institute, Genoa, Italy.
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.
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:Hypotensivechildren treated with CCPD are at increased risk of developing AION, which often results in irreversible blindness.
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