Bilateral posterior ischaemic optic neuropathy after severe diabetic ketoacidosis, cardiopulmonary resuscitation and respiratory failure

Wirth, Christina Doris; Leitner, Christoph; Perrig, Martin (2013). Bilateral posterior ischaemic optic neuropathy after severe diabetic ketoacidosis, cardiopulmonary resuscitation and respiratory failure. BMJ case reports, 2013 BMJ Publishing Group 10.1136/bcr-2012-008291

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A 44-year-old male European with type I diabetes mellitus fell into diabetic ketoacidosis. In the emergency room, he developed an episode of asystole and respiratory failure requiring one cycle of cardiopulmonary resuscitation and extracorporeal membrane oxygenation (ECMO). Waking up 7 days later, he presented a bilateral complete loss of vision. Ophthalmological examination including funduscopy on days 1 and 10, after extubation, showed bilateral large round pupils non-reactive to light and a normal fundus. Neuroimaging studies, including MRI and MRA of the brain, were all within normal limits. A lumbar puncture and comprehensive serological testing excluded an infectious or rheumatic cause. An empirical high-dose intravenous steroid treatment administered for 5 days had no effect on his vision. His eye examination at 1.5 months follow-up showed a normal fundus except for progressive bilateral optic nerve disc pallor, which pointed towards the diagnosis of a posterior ischaemic optic neuropathy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Wirth, Christina Doris, Leitner, Christoph, Perrig, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-790X

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

01 Apr 2014 09:50

Last Modified:

05 Dec 2022 14:29

Publisher DOI:

10.1136/bcr-2012-008291

PubMed ID:

23417383

URI:

https://boris.unibe.ch/id/eprint/44405

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