Clinical Study
Eye (2006) 20, 706–711. doi:10.1038/sj.eye.6701979; published online 8 July 2005
Anterior ischaemic optic neuropathy after coronary artery bypass graft: the role of anaemia in diabetics
A M Mansour1, S T Awwad2, D M Najjar3, A N Sibai4, A M Sibai5, W A Medawar6, I H Hamade1, R S Haddad1, K M Kassak7 and M Y Obeid8
- 1Department of Ophthalmology, American University of Beirut, POB 113-6044, Beirut, Lebanon
- 2Department of Ophthalmology, University of Texas Southwestern, Dallas, TX, USA
- 3Department of Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA
- 4Department of Anesthesiology, American University of Beirut, Beirut, Lebanon
- 5Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
- 6Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- 7Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
- 8Department of Surgery, American University of Beirut, Beirut, Lebanon
Correspondence: AM Mansour, Tel: +961 137 4625; Fax: +961 174 4464; E-mail: dr.ahmad@cyberia.net.lb
Received 6 February 2005; Revised 29 March 2005; Accepted 12 April 2005; Published online 8 July 2005.
Abstract
Purpose
To ascertain factors associated with anterior ischaemic optic neuropathy (AION) following coronary artery bypass graft (CABG) in a Lebanese population.
Methods
A retrospective chart review of consecutive CABG performed over a 5-year period (1995–1999) in one medical centre. A comparison of clinical characteristics was carried out between AION cases and subjects free from AION. The variables analysed included history of diabetes as well as preoperative, intraoperative, or postoperative values of haematocrit, blood sugar, oxygen saturation, and arterial blood pressure.
Results
A total of 1594 persons were included. Three subjects experienced acute visual loss from AION following CABG, all had diabetes mellitus, and two suffered from severe postoperative anaemia. Among diabetics (n=484), the risk of AION was significantly higher in subjects with postoperative haematocrit falling below 22 (28.6%) than the rest (0.21%) (P=0.001). Blood transfusion was given in two subjects with prompt visual recovery.
Conclusions
Severe anaemia in patients undergoing CABG appears to be a risk factor for AION, especially in diabetics, and needs prompt correction to prevent or reverse the ischaemic ocular events.
Keywords:
anaemia, anterior ischaemic optic neuropathy, blood transfusion, coronary artery bypass graft, diabetes mellitus
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