Hypotensive ischemic optic neuropathy and peritoneal dialysis

T L Jackson, C K Farmer, C Kingswood, S Vickers

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

Abstract

PURPOSE: To report anterior ischemic optic neuropathy associated with systemic hypotension in a patient undergoing continuous ambulatory peritoneal dialysis.

METHODS: Case report. A 58-year-old man undergoing continuous ambulatory peritoneal dialysis developed painless blurred vision in both eyes and bilateral optic disk swelling with an altitudinal field defect in the left eye. Twenty-four-hour ambulatory blood pressure monitoring was requested in addition to other routine investigations.

RESULTS: Routine blood pressure measurement in the clinic was 130/86 mm Hg, but ambulatory blood pressure monitoring demonstrated pronounced early morning hypotension with individual readings as low as 91/41 mm Hg.

CONCLUSIONS: Renal dialysis can render patients hypotensive, and this may be associated with anterior ischemic optic neuropathy. The overnight drop in blood pressure may not be appreciated with routine blood pressure measurement. Therefore, 24-hour ambulatory blood pressure monitoring should be considered when investigating patients with suspected anterior ischemic optic neuropathy who are undergoing renal replacement.

Original languageEnglish
Pages (from-to)109-11
Number of pages3
JournalAmerican Journal of Ophthalmology
Volume128
Issue number1
Publication statusPublished - Jul 1999

Keywords

  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Fundus Oculi
  • Humans
  • Hypotension
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Nephrocalcinosis
  • Optic Neuropathy, Ischemic
  • Papilledema
  • Peritoneal Dialysis, Continuous Ambulatory
  • Vision Disorders
  • Visual Acuity

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