Case 1 (12 min), Discussion: panel (3 min)

黃子倫 Tzu-Lun HuangTaiwan Speaker

孫雯軒 Wen-Hsuan SunTaiwan Speaker A Case of Sudden Vision Loss After Cardiac SurgeryA 52-year-old woman with Marfan syndrome and a long-standing history of complex aortic disease presented with sudden blurred vision in her right eye one day after undergoing major cardiovascular surgery. She previously received a Bentall procedure with a mechanical aortic valve and had multiple episodes of progressive aortic dissection requiring repeated arch grafting and endovascular repair. Over the past several months, she had been followed by cardiovascular surgery for dizziness, nausea, intermittent visual disturbance, and episodic chest and back discomfort. Her medical history also included hypertension and chronic anticoagulation, with recent laboratory tests showing elevated PT and INR. After her most recent operation for thoracoabdominal aortic pathology, she noted acute painless visual decline. Her best-corrected visual acuity was 0.05 in the right eye and 0.5 in the left, with a right relative afferent pupillary defect. The intraocular pressure showed 8 mmHg in the right eye and 10 mmHg in the left eye. Fundus examination revealed only subtle optic pallor without disc edema or cherry-red spot. Further image studies were arranged.