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Deze abstract is toegekend aan sessie BOG-SBO: Medisch netvlies/ Rétine médicale
TitelAcute macular neuroretinopathy after caesarian section
Abstract Nr.244
DoelTo report a case of acute macular neuroretinopathy (AMN) probably related to hypotension during Caesarian section.
MethodesA 30-year old woman was examined after she was referred with bilateral U-shaped paracentral scotomata following a Caesarian section (C-section) under epidural anaesthesia without epinephrine.
The patient was followed up during a period of two years and underwent a full clinical work-up as well as extensive additional testing including fundoscopy, fluorescein angiography (FA), visual fields (VF), optical coherence tomography (OCT), pattern electroretinography (pERG) and pattern visual evoked potentials (pVEP).
ResultatenThe patient was known to suffer from arterial hypotension. During the C-section the patient very briefly lost consciousness.
At presentation BCVA was 12/10. VF analysis revealed bilateral parafoveal U-formed scotomata. Initial fundoscopy and FA showed petaloid macular lesions with a darker aspect. Later on both alterations of the retinal pigment epithelium and fine white deposits were seen in the macular area. The N95 of the pERG was mildly subnormal, while on full-field flash ERG only a slightly reduced photopic response was noted. The pVEP responses had small amplitudes and normal latencies. On OCT a band of higher reflectivity overlying the RPE/CC complex was detectable in the (para-) foveal area, as well as outer retinal thinning in the superior macula, congruous with the scotomata.
During follow-up, the scotomata gradually diminished in density, albeit that they never cleared up completely.
ConclusieAMN can develop during a C-section under epidural anaesthesia without epinephrine.
Auteur 1
NaamCORVER
InitialenHD
InstituutUGent
StadGent
Auteur 2
NaamGOETHALS
InitialenT
InstituutMaria's Voorzienigheid Hospital
StadKortrijk
Auteur 3
NaamDE LAEY
InitialenJJ
InstituutUGent
StadGent
Auteur 4
NaamLEROY
InitialenBP
InstituutUGent
StadGent
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