Acute visual loss after preoperative embolization of an ethmoidal metastasis

Hufendiek, Karsten and Hufendiek, Katerina and Finkenzeller, Thomas and Helbig, Horst and Framme, Carsten (2012) Acute visual loss after preoperative embolization of an ethmoidal metastasis. INTERNATIONAL OPHTHALMOLOGY, 32 (2). pp. 165-169. ISSN 0165-5701, 1573-2630

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Abstract

An unintentional embolization of retinal arteries is rare and has been documented as a complication after embolization of arteries supplying head and neck tumors. However, occlusion of the central retinal artery with severe loss of vision has never been reported to be a complication from embolization of tumor-supplying ethmoidal branches of the ophthalmic artery. A 40 year-old male patient with a history of right nephrectomy for renal cell carcinoma underwent preoperative radiological embolization of an ethmoidal metastasis after having experienced a life-threatening sinus bleeding. Repeated probing of the ophthalmic artery with an endovascular microcatheter for particle embolization of the tumor-supplying arteries was performed under anticoagulation with heparin. Postoperatively, a standard ophthalmological examination including extended vascular evaluation by angiography was performed. After extended probing of the ophthalmic artery a marked reduction in its blood flow occurred. Despite post-interventional imaging showing persisting perfusion of the central retinal and ciliary arteries, the patient developed complete loss of vision on this side four days later. At this time fundoscopy and fluorescein angiography revealed a recanalized central artery occlusion, while indocyanin angiography showed infarctions of the choroid. Radiological intervention via the ophthalmic artery can result in complete loss of vision, even after limited and transient obstruction of the vessel.

Item Type: Article
Uncontrolled Keywords: ; Acute visual loss; Central retinal artery occlusion; Choroidal infarction; Microcatheter embolization; Ethmoidal metastasis
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Augenheilkunde
Medicine > Lehrstuhl für Strahlentherapie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 18 May 2020 08:37
Last Modified: 18 May 2020 08:37
URI: https://pred.uni-regensburg.de/id/eprint/19020

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