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Anesthesiology CME Program  |   October 2006
Instructions for Obtaining Journal CME Credit
Article Information
Anesthesiology CME Program
Anesthesiology CME Program   |   October 2006
Instructions for Obtaining Journal CME Credit
Anesthesiology 10 2006, Vol.105, 867-868. doi:
Anesthesiology 10 2006, Vol.105, 867-868. doi:
Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
  1. Read the article by Lee et al.  entitled “The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss” on page 652 and the accompanying editorial by Warner entitled “Postoperative visual loss: Experts, data, and practice” on page 641 of this issue.

  2. Review the questions and other required information for CME program completion (published in both the print and online journal).

  3. When ready, go to the CME Web site: . Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.

The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education programs for physicians.
The American Society of Anesthesiologists designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit  ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Purpose:  The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience:  Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives:  After reading this article, participants should have a better understanding of the problem of postoperative visual loss associated with anesthesia and surgery.
Disclosure Information:
Authors  –Lorri A. Lee, M.D., Steven Roth, M.D., Karen L. Posner, Ph.D., Frederick W. Cheney, M.D., Robert A. Caplan, M.D., Nancy J. Newman, M.D., and Karen B. Domino, M.D., M.P.H.
Grants or research support:  None
Consultantships or honoraria:  None
The article authored by Drs. Lee, Roth, Posner, Cheney, Caplan, Newman, and Domino was supported solely from institutional and/or departmental sources.
Author  –Mark A. Warner, M.D.
Grants or research support:  None
Consultantships or honoraria:  None
The article authored by Dr. Warner was supported solely from institutional and/or departmental sources.
Question Writer  –Peter L. Bailey, M.D.
Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Article Questions
Based on the article by Lee et al.  entitled “The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss”and its accompanying editorial by Warner entitled “Postoperative visual loss: Experts, data, and practice”in the October issue of Anesthesiology, choose the one correct answer for each question:
1. Which of the following statements concerning postoperative visual loss (POVL) is most  likely true?
A. POVL is most often associated with direct trauma to the eye.
B. The incidence of POVL is consistently greater than 5% after major spine surgery.
C. Ischemic optic neuropathy is the most common cause of POVL.
D. Central retinal artery occlusion is the most common cause of POVL.
2. Which of the following statements concerning the diagnosis of POVL is most  likely true?
A. An exaggerated pupillary light reflex suggests a diagnosis of central retinal artery occlusion.
B. An exaggerated pupillary light reflex suggests a diagnosis of anterior ischemic optic neuropathy.
C. A normal funduscopic exam in the early postoperative period assures that POVL will not occur.
D. Funduscopic detection of an edematous disc in the early postoperative period is consistent with a diagnosis of anterior ischemic optic neuropathy.
3. Which of the following statements concerning factors associated with POVL in the American Society of Anesthesiologists (ASA) Postoperative Visual Loss Registry is most  likely true?
A. Ischemic optic neuropathy occurred more frequently in females.
B. Greater than 40% of the patients who experienced POVL carried a diagnosis of hypertension.
C. The majority of patients who experienced ischemic optic neuropathy had severe systemic problems (i.e.  , ASA physical status III).
D. Glaucoma was present in 25% of the patients who experienced POVL.
4. Which of the following statements concerning surgery in patients in the ASA Postoperative Visual Loss Registry is most  likely true?
A. The majority of the spine surgery cases involved fusion and/or instrumentation affecting at least three levels.
B. Approximately one third of the patients were supine during surgery.
C. Use of the Jackson frame prevented POVL.
D. Failure to document eye checks was noted in all POVL cases.
5. Which of the following statements concerning the anesthetic management of patients in the ASA Postoperative Visual Loss Registry is most  likely true?
A. Systemic hypotension (systolic blood pressure <80 mmHg) was documented in more than 90% of cases.
B. Intravenous anesthesia was identified as a risk factor for POVL.
C. Anemia (hematocrit <25%) occurred in more than 90% of patients.
D. POVL was found with all the commonly used inhaled anesthetics.
6. Which of the following statements concerning the ophthalmologic findings in patients in the ASA Postoperative Visual Loss Registry is most  likely true?
A. POVL usually involved just one eye.
B. Affected patients did not open their eyes postoperatively.
C. Recovery of vision was most often clinically insignificant.
D. Anterior ischemic optic neuropathy was the most common diagnosis.