Ischemic optic neuropathy after hemorrhage from a cornual ectopic gestation.

Abstract

A case of ischemic optic neuropathy resulting from uterine hemorrhage is reported in which a 37-year-old white woman, gravida 1, para 0, was diagnosed at 8 weeks' gestation with a ruptured ectopic pregnancy. After diagnostic laparoscopy the patient underwent a minilaparotomy, cornual wedge resection, and right salpingectomy with a total estimated blood loss of 3000 ml. Her postoperative course was uneventful until postoperative day 4, when the patient complained of vision loss for the last 1 to 2 days, total body edema, and headache. Ophthalmologic examination revealed findings consistent with ischemic optic neuropathy. Multiple studies of the cerebrospinal fluid were negative, as were computed tomography studies and magnetic resonance imaging of the head. Ischemic optic neuropathy, whose pathogenesis is still unclear, is a rare complication of massive hemorrhage and may cause permanent vision loss.