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Recovery of vision between CRAO and ION groups was not significantly different ( P = 0.11).
![aion database tissue aion database tissue](https://ars.els-cdn.com/content/image/1-s2.0-S002239561000364X-gr2.jpg)
In contrast to the ION group, there were no cases of bilateral CRAO ( P = 0.001). Deliberate hypotension was used in 4 of 10 CRAO cases. The mean lowest hematocrit was higher in the CRAO than in ION cases, although not significantly different ( P = 0.075 table 5). The mean anesthetic duration and median EBL were significantly less in the CRAO compared with the ION group ( P = 0.002 and 0.001, respectively table 5). Eye checks were not performed in 3 cases (missing data in 1 case). Eye checks were performed in 6 of 10 cases at intervals ranging from 30 min to only once during a 10-h case. Mayfield pins were not used for any CRAO cases, in contrast to 19% of ION cases ( P = 0.001). Horseshoe headrests were used in 3 cases, foam pads were used in 2, and miscellaneous headrests were used in 5. The mean age for the 10 patients with CRAO was 46 ± 13 yr ( table 5). Follow-up of ophthalmologic examinations was inconsistent and varied from only the initial examination to 4 yr postoperatively. There was some degree of recovery of vision in 42% of ION cases ( table 5), although improvement in vision was often clinically insignificant ( e.g. , light/dark perception to hand motion only). PION was diagnosed in 67% of all ION cases, AION was diagnosed in 23% of cases, and unspecified ION was diagnosed in 10% of cases ( table 1). Visual fields were restricted in 134 of 138 affected eyes (97%), and complete blindness with loss of light perception occurred in 64 of 138 affected eyes (47 patients). There was associated periocular trauma in only one case ( table 5).
AION DATABASE TISSUE FULL
Full or partial eye opening was noted immediately postoperatively in 43 patients, inability to open one or both eyes was noted in 12 patients, and eye opening information was missing in 28 patients. The median onset time of reporting visual loss postoperatively was 15 h (range, 0–168 h), with the exception of one patient who was mechanically ventilated for 2 weeks postoperatively and reported complete blindness 2 days after extubation. Of the 83 patients with ION, 55 (66%) had documented bilateral involvement, for a total of 138 affected eyes ( table 5). Lack of an early funduscopic examination before the appearance of isolated optic nerve pallor was categorized as unspecified ION. Eventual optic nerve pallor was consistent with both AION and PION.
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Criteria consistent with posterior ischemic optic neuropathy (PION) included a normal early funduscopic examination with a relative afferent pupillary defect or an absent pupillary light reflex. A diagnosis of anterior ischemic optic neuropathy (AION) required an early funduscopic examination demonstrating an edematous disc with or without peripapillary flame-shaped hemorrhages and a relative afferent pupillary defect or reduced pupillary light reflex. For central retinal artery occlusion (CRAO), these criteria included a pale ischemic retina with a pathognomonic cherry-red spot at the macula and a relative afferent pupillary defect or reduced pupillary light reflex. Classification of the specific lesion was based on ophthalmologic diagnosis or, if unavailable, findings consistent with standard diagnostic criteria. Detailed information on the ophthalmologic examination for each eye was obtained including type of visual deficit ( i.e. , decreased visual acuity, visual field deficit, or complete loss of vision), time when visual symptoms were first noted, funduscopic examination, and ophthalmologic diagnosis.