Abstract
Purpose: :
Visual field defects after uncomplicated vitrectomy have been reported but poorly explained. We describe two cases of nonarteritic anterior ischemic optic neuropathy (NAION) observed following vitrectomy. We reviewed the literature for cases of post–vitrectomy visual field defects for evidence of optic nerve damage.
Methods: :
Two patients developed optic disc edema and features of an optic neuropathy after uncomplicated pars plana vitrectomy. A systematic literature search for prior reports of visual field defects or ischemic optic neuropathy following vitrectomy was performed. Additional studies were identified from bibliographies of the retrieved articles.
Results: :
The incidence of visual field defects following vitrectomy has varied from 1–71% across all reports. We discovered 160 (14.5%) cases of unexplained visual field defects following vitrectomy out of 1104 patients. Of these, 31 eyes (19.4%) have shown some sign of optic nerve damage following vitrectomy, including pallor, relative afferent pupillary defect, and intrapapillary hemorrhage.
Conclusions: :
NAION may develop following vitrectomy. ‘Visual field defects’ following vitrectomy are common and many of the involved eyes demonstrate evidence of optic nerve damage, some of which may have represented ischemic optic neuropathy. Vitreoretinal surgeons should recognize ischemic optic neuropathy as a potential complication of vitrectomy.
Keywords: neuro-ophthalmology: optic nerve • visual fields • vitreoretinal surgery