June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Ischemic Optic Neuropathy in Cardiac Surgery: Incidence and Risk Factors in the United States from the National Inpatient Sample 1998-2013
Author Affiliations & Notes
  • Steven Roth
    Anesthesiology, Univ of Illinois, Chicago, Illinois, United States
    Ophthalmology, University of Illinois, Chicago, Illinois, United States
  • Daniel S Rubin
    Anesthesia and Critical Care, University of Chicago, Chicago, Illinois, United States
  • Monica Matsumoto
    Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States
  • Heather Moss
    Ophthalmology, University of Illinois, Chicago, Illinois, United States
  • Charlotte E Joslin
    Ophthalmology, University of Illinois, Chicago, Illinois, United States
    School of Public Health, University of Illinois, Chicago, Illinois, United States
  • Avery Tung
    Anesthesia and Critical Care, University of Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Steven Roth, None; Daniel Rubin, None; Monica Matsumoto, None; Heather Moss, None; Charlotte Joslin, None; Avery Tung, None
  • Footnotes
    Support  NIH EY10343, RR024999, TR002003, EY024345, EY001792
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3868. doi:
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      Steven Roth, Daniel S Rubin, Monica Matsumoto, Heather Moss, Charlotte E Joslin, Avery Tung; Ischemic Optic Neuropathy in Cardiac Surgery: Incidence and Risk Factors in the United States from the National Inpatient Sample 1998-2013. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3868.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Ischemic optic neuropathy is the most common form of perioperative visual loss, with highest incidence in cardiac and spinal fusion surgery. To date, potential risk factors have been identified in cardiac surgery by only small, single institution studies. To determine the preoperative risk factors for ischemic optic neuropathy, we used the National Inpatient Sample, a database of inpatient discharges for non-federal hospitals in the United States.

Methods : Adults ≥ 18 years of age admitted for coronary artery bypass grafting, heart valve surgery, or left ventricular assist device insertion in National Inpatient Sample from 1998-2013 were included (Fig 1 shows study design). Ischemic optic neuropathy rates and risk factors were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification code. Risk of ischemic optic neuropathy was evaluated by multivariable logistic regression.

Results : 5,559,395 discharges met inclusion criteria with 794 (0.014%) cases of ischemic optic neuropathy. The average yearly incidence was 1.43/10,000 cardiac procedures, with no change during the study period (p = 0.57). Conditions increasing risk were carotid artery stenosis (odds ratio, OR = 2.70), stroke (OR = 3.43), diabetic retinopathy (OR = 3.83), hypertensive retinopathy (OR = 30.09), macular degeneration (OR = 4.50), glaucoma (OR = 2.68), and cataract (OR = 5.62). Female sex (OR = 0.59) and uncomplicated diabetes mellitus type 2 (OR = 0.51) decreased risk.

Conclusions : The incidence of ischemic optic neuropathy in cardiac surgery did not change over the study period. Development of ischemic optic neuropathy after cardiac surgery is associated with carotid artery stenosis, stroke, and degenerative eye conditions.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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