Rapidly Sequential Vision Loss From Posterior Ischemic Optic Neuropathy Due to Methicillin-Susceptible Staphylococcus Aureus Bacteremia

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Title Rapidly Sequential Vision Loss From Posterior Ischemic Optic Neuropathy Due to Methicillin-Susceptible Staphylococcus Aureus Bacteremia
Creator Sultan S. Aldrees, Jonathan A. Micieli
Affiliation Department of Ophthalmology and Vision Sciences (SSA, JAM), University of Toronto, Toronto, Canada; Department of Ophthalmology (SSA), King Saud University, Riyadh, Saudi Arabia; Division of Neurology (JAM), Department of Medicine, University of Toronto, Toronto, Canada; Kensington Vision and Research Centre (JAM), Toronto, Canada; and Department of Ophthalmology (JAM), St. Michael's Hospital, Toronto, Canada
Abstract A 63-year-old man with a history of high-grade bladder cancer was admitted to the intensive care unit (ICU) with renal failure and methicillin-susceptible Staphylococcus aureus bacteremia originating from his nephrostomy tube. While in the ICU, he had painless, severe loss of vision in the right eye followed by his left eye 12 hours later. Visual acuity was no light perception in each eye. He was anemic, and before each eye lost vision, there was a significant decrease in blood pressure. Dilated fundus examination was normal, and MRI showed hyperintense signal in the bilateral intracanalicular optic nerves on diffusion-weighted imaging and a corresponding low signal on apparent diffusion coefficient imaging. He was diagnosed with bilateral posterior ischemic optic neuropathies (PION), and despite transfusion and improvement in his systemic health, his vision did not recover. PION may be seen in the context of sepsis, and patients with unilateral vision loss have a window for optimization of risk factors if a prompt diagnosis is made.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2020-09
Type Text
Source Journal of Neuro-Ophthalmology, September 2020, Volume 40, Issue 3
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s60g98j7
Setname ehsl_novel_jno
Date Created 2020-09-15
Date Modified 2021-05-06
ID 1592981
Reference URL https://collections.lib.utah.edu/ark:/87278/s60g98j7
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