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Case Reports
. 2024 Oct 23:2024:6618094.
doi: 10.1155/2024/6618094. eCollection 2024.

Sudden Visual Loss After Vitreoretinal Surgery: A Case Report

Agostino Salvatore Vaiano  1 , Fabio Garavelli  1 , Antonio Greco  1 , Riccardo Merli  1 , Alessandro De Filippis  1 , Andrea Greco  1 , Maria Marenco  1
Affiliations
Case Reports

Sudden Visual Loss After Vitreoretinal Surgery: A Case Report

Agostino Salvatore Vaiano et al. Case Rep Ophthalmol Med. .

Abstract

A 51-year-old male underwent vitrectomy with retrobulbar anesthesia for retinal detachment. Post surgery, he experienced systemic hypotension which normalized after 3 h. The day after, he complained of a central scotoma in the operated eye. Intraocular pressure was normal, but fundus examination revealed hemorrhages and whitening along the papillomacular bundle and macula, with additional whitening in the upper midperipheral region. Multimodal imaging confirmed branch retinal vein, artery, and cilioretinal artery occlusion. Further examination revealed mild-to-moderate obstructive sleep apnea syndrome. Vascular occlusions are potential complications of vitreoretinal surgery, warranting thorough preoperative assessment for underlying risk factors, even if causative mechanism is still unknown.

Keywords: case report; visual loss; vitreoretinal surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Left eye 4 days after surgery. (A) Slit lamp's fundus photo showing hemorrhages and whitening along the papillomacular bundle and in the macular region. (B) Optical coherence tomography showing hyperreflectivity of inner retinal layers in the macular area with increased central macular thickness.
Figure 2
Figure 2
Fifteen days postoperatively. (A) Fundus photo of the right eye showing cilioretinal artery and (B) of the left eye revealing macular and papillomacular bundle whitening, superior midperipheral retinal whitening. (C, D) Fluorescein angiography indicating perfusion absence in multiple areas and obscured choroidal fluorescence. (E, F) Visual field indicating central scotoma and inferior altitudinal defect.
Figure 3
Figure 3
Left eye at 4-month follow-up. (A, B) Fundoscopy showing retinal hemorrhages and whitening along papillomacular bundle and macula, and whitening in the upper quadrant. (C) Optical coherence tomography revealing macular thinning. (D, E) Superficial and deep vascular complex in optical coherence tomography angiography showing the absence of perfusion in the macula and adjacent upper region.
See this image and copyright information in PMC

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