Anterior ischemic optic neuropathy. VIII. Clinical features and pathogenesis of post-hemorrhagic amaurosis

S S Hayreh

doi:10.1016/S0161-6420(87)33273-7

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Anterior ischemic optic neuropathy. VIII. Clinical features and pathogenesis of post-hemorrhagic amaurosis

Journal article

Peer reviewed

Anterior ischemic optic neuropathy. VIII. Clinical features and pathogenesis of post-hemorrhagic amaurosis

S S Hayreh

Ophthalmology (Rochester, Minn.), Vol.94(11), pp.1488-1502

11/1987

DOI: 10.1016/S0161-6420(87)33273-7

PMID: 3500445

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Abstract

Visual disturbance after marked and/or recurrent blood loss has been known for at least 25 centuries, since Hippocrates; however, so far its clinical features have been controversial and its pathogenesis enigmatic. The author studied seven patients, four of whom were seen soon after the visual loss and followed prospectively. A detailed review of the extensive literature and analysis of the cases provide relevant information on the subject. The blood loss is usually from the gastrointestinal (GI) tract, less often from other sites. There is typically a time lag between the bleeding and the onset of visual loss--usually up to 10 days, less often even 2 to 3 weeks. The ocular findings are typically those of anterior ischemic optic neuropathy (AION) and are usually bilateral. Considerable evidence has accumulated that blood loss, with or without arterial hypotension, causes increase in release of renin and endogenous vasoconstrictor agents (e.g., angiotensin, epinephrine, and vasopressin) because of activation of the sympathoadrenergic system and vasomotor center. Our experimental studies on renovascular malignant hypertension indicate that endogenous vasoconstrictor agents produce choroidal ischemia and AION. In view of all the evidence, it is postulated that in the production of AION after blood loss, release of endogenous vasoconstrictor agents is probably a very important factor, with arterial hypotension an additional factor; increased platelet aggregation may also play a role.

Blindness - diagnosis

Fluorescein Angiography

Gastrointestinal Hemorrhage - complications

Humans

Ischemia - diagnosis

Male

Middle Aged

Optic Atrophy - diagnosis

Optic Nerve - blood supply

Optic Neuritis - diagnosis

Peptic Ulcer Hemorrhage - complications

Visual Acuity

Visual Fields

Details

Title: Subtitle: Anterior ischemic optic neuropathy. VIII. Clinical features and pathogenesis of post-hemorrhagic amaurosis
Creators: S S Hayreh - University of Iowa
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.94(11), pp.1488-1502
DOI: 10.1016/S0161-6420(87)33273-7
PMID: 3500445
ISSN: 0161-6420
eISSN: 1549-4713
Grant note: EY-1151 / NEI NIH HHS
Language: English
Date published: 11/1987
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9984182972102771

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