Bilateral posterior ischemic optic neuropathy after lumbar spine surgery.

PURPOSE: To report a case of bilateral posterior ischemic optic neuropathy (PION) in a healthy young patient after lumbar spine surgery which was initially diagnosed as functional visual loss.

DESIGN

Observational case report.

PARTICIPANT: A 33-year-old woman who experienced visual loss in the immediate postoperative period after a lumbar spine fusion.

TESTING: Serial visual field testing and fundus examinations, ERG.

RESULTS

Bilateral PION was confirmed 2 months postoperatively with the development of bilateral optic disc pallor and a normal ERG.

CONCLUSION

Young patients without vascular risk factors may develop bilateral PION after otherwise uncomplicated lumbar spine surgery. In subjects complaining of visual loss in the postoperative period who have a normal fundus and normal neuroimaging, a diagnosis of PION should be suspected, and close follow-up is warranted.