Anesthesia-Related Neurologic Risk in Patients of Venezuelan Descent: Implications for Ophthalmology.

PURPOSE: To alert ophthalmologists to an emerging pattern of catastrophic neurologic injury following general anesthesia in patients of maternal Venezuelan descent, to describe the proposed genetic mechanism, and to provide practical guidance for ophthalmologists regarding this high-risk population.

DESIGN

Perspective SUBJECTS: Patients of maternal Venezuelan descent who experienced neurologic complications following elective surgical procedures under general anesthesia, including 1 pediatric patient undergoing strabismus surgery who had prior exposure to general anesthesia. Approximately 40 cases have been identified as of April 2026, spanning multiple countries, including the United States, Chile, Germany, Spain, and Guyana.

METHODS

Narrative review of emerging case reports, genetic analyses, and evolving clinical guidance for ophthalmologists pertaining to anesthesia-related neurologic injury in patients carrying the m.11232T>C variant of the mitochondrial gene MT-ND4. Recommendations were synthesized and applied to the ophthalmologic clinical context.

CONCLUSIONS

Emerging evidence in the past year has established a consistent clinical pattern and a biologically plausible mechanism for these cases of severe neurologic injury following general anesthesia in otherwise healthy patients of Venezuelan descent. By incorporating targeted screening, ensuring early anesthesiology consultation, and adapting perioperative management, ophthalmologists are in a unique position to help prevent devastating outcomes.