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Electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging

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Abstract

Purpose

To report the electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging.

Methods

A 45-year-old male presented with bilateral visual loss and difficulty in walking following a suicide attempt by hanging six months ago. He underwent a complete ophthalmologic examination, posterior segment optical coherence tomography (OCT), various electrophysiological tests and neuroimaging.

Results

His bilateral best-corrected visual acuity was logMAR 1.08. Intraocular pressures and ocular examination were normal except for bilateral temporal disk pallor. Macular OCT showed bilateral ganglion cell layer-inner plexiform layer complex thinning. Electroretinogram showed reduced b/a wave amplitude ratio in all the dark- and light-adapted International Society for Clinical Electrophysiology of Vision protocols in both the eyes. Pattern-reversal visually evoked potential (VEP) showed delayed latency of the P100 component in both the eyes. Electrooculography showed a normal light peak-to-dark trough ratio in both the eyes.

Magnetic resonance imaging (MRI) brain showed chronic infarct and gliosis in both the occipital lobes. MR angiography showed pruning of P4 segments of both the posterior cerebral artery. Perfusion imaging showed reduction of perfusion in both the parieto-occipital lobes.

Conclusion

Hanging survivors can develop visual loss after their recovery. The visual loss may be a result of simultaneous ischemic insult to the occipital lobe cortex, optic nerve and retina.

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Authors and Affiliations

Authors

Contributions

PK was involved in patient management, analysis and interpretation of the investigations and writing the article. KNJ was involved in patient management and final approval of the article. AR was involved in electrophysiological testing, analysis and interpretation and final approval of the article. MK was involved in involved in patient management and final approval of the article. AK was involved in involved in patient management and final approval of the article.

Corresponding author

Correspondence to Piyush Kohli.

Ethics declarations

Conflict of Interest Statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

This study was approved by the Research Ethics Committee of Aravind Eye Hospital, Madurai, Tamil Nadu, India and adhered to the tenets of the Declaration of Helsinki.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on the welfare of animals

This article does not contain any studies with animals performed by any of the authors.

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The patient and his guardian have given their written informed consent.

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Kohli, P., Jayasri, K.N., Rupa, A. et al. Electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging. Doc Ophthalmol 143, 331–337 (2021). https://doi.org/10.1007/s10633-021-09846-8

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  • DOI: https://doi.org/10.1007/s10633-021-09846-8

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