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Bilateral visual loss complicating liposuction in a patient with idiopathic intracranial hypertension.

Ribeiro Monteiro ML, Moura FC, Cunha LP

Division of Ophthalmology, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil. mlrmonteiro@terra.com.br

A 34-year-old obese woman developed blurred vision in both eyes soon after large-volume liposuction of the dorsum and gluteus region bilaterally associated with abdominal dermolipectomy. An ophthalmic examination revealed severe bilateral visual loss and pallid optic disc edema. The patient gave a history of transient obscurations of vision in the past. Neuroimaging studies were non-revealing, but a lumbar puncture disclosed a markedly elevated intracranial pressure. The patient was diagnosed as having had bilateral ischemic optic neuropathy superimposed on pre-existing idiopathic intracranial hypertension (IIH). Acetazolamide treatment was used. Some visual improvement occurred, and optic disc edema evolved into severe optic disc pallor. This case shows that visual loss from optic disc infarction may be a devastating complication of high-volume liposuction in patients with underlying IIH. Because liposuction is frequently performed on obese patients, physicians should screen for signs and symptoms of IIH before undertaking this procedure.

Published 6 March 2006 in J Neuroophthalmol, 26(1): 34-7.
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