Am J Ophthalmol. 2026 May 15:S0002-9394(26)00237-0. doi: 10.1016/j.ajo.2026.05.004. Online ahead of print.
ABSTRACT
PURPOSE: To alert ophthalmologists to an emerging pattern of catastrophic neurologic injury following general anesthesia in patients of maternal Venezuelan descent, to describe the proposed genetic mechanism, and to provide practical guidance for ophthalmologists regarding this high-risk population.
DESIGN: Perspective SUBJECTS: Patients of maternal Venezuelan descent who experienced neurologic complications following elective surgical procedures under general anesthesia, including one pediatric patient undergoing strabismus surgery who had prior exposure to general anesthesia. Approximately forty cases have been identified as of April 2026, spanning multiple countries, including the United States, Chile, Germany, Spain, and Guyana.
METHODS: Narrative review of emerging case reports, genetic analyses, and evolving clinical guidance for ophthalmologists pertaining to anesthesia-related neurologic injury in patients carrying the m.11232T>C variant of the mitochondrial gene MT-ND4. Recommendations were synthesized and applied to the ophthalmologic clinical context.
CONCLUSIONS: Emerging evidence over the past year has established a consistent clinical pattern and biologically plausible mechanism for these cases of severe neurologic injury following general anesthesia in otherwise healthy patients of Venezuelan descent. By incorporating targeted screening, ensuring early anesthesiology consultation, and adapting perioperative management, ophthalmologists are in a unique position to help prevent devastating outcomes.
PMID:42142861 | DOI:10.1016/j.ajo.2026.05.004