Changes in Retinal Nerve Fiber Layer and Macular Ganglion Cell-Inner Plexiform Layer Thickness after Spinal Surgery in the Prone Position

Thoranis  Deeprasertwit; Piya-Orn  Bunyaprateeprat; Niphon  Chirapapaisan; Sirichai  Wilartratsami; Pratuangsri  Chonphimai; Nuchanat  Ritthison; Yanee  Mukdar; Akarawit Eiamsamarng

doi:10.33192/smj.v76i10.268907

Authors

Thoranis Deeprasertwit Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Piya-Orn Bunyaprateeprat Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Niphon Chirapapaisan Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sirichai Wilartratsami Department of Orthopedics Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Pratuangsri Chonphimai Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Nuchanat Ritthison Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Yanee Mukdar Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Akarawit Eiamsamarng Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v76i10.268907

Keywords:

Posterior ischemic optic neuropathy, Prone position, Retinal nerve fiber layer (RNFL), Macular ganglion cell-inner plexiform layer (GCIPL), Spinal surgery

Abstract

Objective: Postoperative visual loss resulting from posterior ischemic optic neuropathy (PION) after spinal surgery is rare but devastating. A potential risk factor is the prone position during prolonged spinal surgery. We hypothesized that if this risk factor is linked to PION, the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) should decrease post-surgery.

Materials and Methods: The prospective cohort study was conducted in patients undergoing spinal surgery in the prone position. The RNFL and GCIPL thickness by optical coherence tomography before and after spinal surgery (6-week, 3-month post-operative) were analyzed.

Results: Nineteen patients (38 eyes) completed the study with three follow-up timepoints. The mean age was 53.78+/-12.71 year. No significant changes were observed in the RNFL thickness and macular ganglion cell-inner plexiform layer changes at the 6 weeks and 3 months follow-ups, except for the RNFL at the inferior quadrant at 6 weeks follow-up. There were also no patients who experienced visual loss.

Conclusion: A transient decrease in RNFL thickness in the inferior quadrant was observed at the 6-week post-operative follow-up after spinal surgery. The prone position during surgery may be an intraoperative factor associated with the development of perioperative PION in patients undergoing spinal procedures.

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