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Cet abstract a été assigné à session BOG-SBO: Medisch netvlies/ Rétine médicale
TitreAcute macular neuroretinopathy after caesarian section
Abstract Nr.244
ButTo report a case of acute macular neuroretinopathy (AMN) probably related to hypotension during Caesarian section.
MéthodesA 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).
RésultatsThe 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.
ConclusionAMN can develop during a C-section under epidural anaesthesia without epinephrine.
Auteur 1
NomCORVER
InitialesHD
InstitutUGent
VilleGent
Auteur 2
NomGOETHALS
InitialesT
InstitutMaria's Voorzienigheid Hospital
VilleKortrijk
Auteur 3
NomDE LAEY
InitialesJJ
InstitutUGent
VilleGent
Auteur 4
NomLEROY
InitialesBP
InstitutUGent
VilleGent
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