Central Retinal Artery Occlusion After the Endovascular Treatment of Unruptured Ophthalmic Artery Aneurysm: A Case Report and a Literature Review

Overview

Journal NMC Case Rep J

Specialty Neurology

Date 2017 Jul 1

PMID 28664002

Citations 5

Authors

Alaa Mohammed Elkordy

Kenichi Sato

Yasuhide Inoue

Yui Mano

Yasushi Matsumoto

Akira Takahashi

Teiji Tominaga

Affiliations

Soon will be listed here.

Abstract

Endovascular coil embolization for ophthalmic artery (OphA) aneurysms has a risk of occlusion of the OphA, which can lead to loss of vision. The authors report a patient with unruptured OphA aneurysm which treated with endovascular coiling and were complicated by blindness due to OphA thromboembolic occlusion after the procedure. The OphA successfully recanalized using local intra-arterial fibrinolysis with complete regain of visual acuity. The risk of visual loss due to thromboembolic complications cannot be ignored during endovascular coiling of the OphA aneurysm despite of good retrograde flow during OphA occlusion test using a balloon catheter. Rapid intervention is required for recovering visual disturbance in such a situation.

Citing Articles

Retinal artery/arteriole occlusion risks after endovascular treatment for unruptured intracranial aneurysm.

Kim H, Kim M, Kim S, Chang M, Kim D, Kim B Stroke Vasc Neurol. 2023; 9(3):295-305.

PMID: 37793900 PMC: 11221302. DOI: 10.1136/svn-2023-002563.

Comparison of Visual Outcomes of Ophthalmic Artery Aneurysms Treated with Microsurgical Clipping and Endovascular Coiling.

Lu G, Chung J, Park J, Ahn J, Kwun B, Lee D Neurointervention. 2022; 17(1):18-27.

PMID: 35045591 PMC: 8891588. DOI: 10.5469/neuroint.2020.00185.

Points to consider when evaluating three-dimensional digital subtraction angiography of intracranial aneurysms and their effects on treatment.

Yardimcioglu I, Onal Y, Velioglu M, Karakas H Turk J Med Sci. 2021; 51(3):1428-1438.

PMID: 33726484 PMC: 8283457. DOI: 10.3906/sag-2008-134.

Visual complications after coil embolization of internal carotid artery aneurysms at the ophthalmic segment.

Michishita S, Ishibashi T, Yuki I, Urashima M, Karagiozov K, Kodama T Interv Neuroradiol. 2021; 27(5):622-630.

PMID: 33615875 PMC: 8493353. DOI: 10.1177/1591019921996886.

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis.

Wu X, Chen S, Li S, Zhang J, Luan D, Zhao S PLoS One. 2018; 13(8):e0202154.

PMID: 30157206 PMC: 6114710. DOI: 10.1371/journal.pone.0202154.

References

Castillo Jr B, De Alba F, Thornton J, DEBRUN G, Pulido J . Retinal artery occlusion following coil embolization of carotid-ophthalmic aneurysms. Arch Ophthalmol. 2000; 118(6):851-2. View

Hoh B, Carter B, Budzik R, Putman C, Ogilvy C . Results after surgical and endovascular treatment of paraclinoid aneurysms by a combined neurovascular team. Neurosurgery. 2001; 48(1):78-89; discussion 89-90. DOI: 10.1097/00006123-200101000-00014. View

Kim B, Jeon P, Kim K, Yang N, Kim S, Kim H . Endovascular treatment of unruptured ophthalmic artery aneurysms: clinical usefulness of the balloon occlusion test in predicting vision outcomes after coil embolization. J Neurointerv Surg. 2015; 8(7):696-701. DOI: 10.1136/neurintsurg-2015-011800. View

Fulkerson D, Horner T, Payner T, Leipzig T, Scott J, DeNardo A . Results, outcomes, and follow-up of remnants in the treatment of ophthalmic aneurysms: a 16-year experience of a combined neurosurgical and endovascular team. Neurosurgery. 2009; 64(2):218-29. DOI: 10.1227/01.NEU.0000337127.73667.80. View

Kanagalingam S, Gailloud P, Tamargo R, Subramanian P, Miller N . Visual sequelae after consensus-based treatment of ophthalmic artery segment aneurysms: the Johns Hopkins experience. J Neuroophthalmol. 2011; 32(1):27-32. DOI: 10.1097/WNO.0b013e31823b6c60. View

Richard G, Lerche R, Knospe V, Zeumer H . Treatment of retinal arterial occlusion with local fibrinolysis using recombinant tissue plasminogen activator. Ophthalmology. 1999; 106(4):768-73. DOI: 10.1016/S0161-6420(99)90165-3. View

Beatty S, Au Eong K . Local intra-arterial fibrinolysis for acute occlusion of the central retinal artery: a meta-analysis of the published data. Br J Ophthalmol. 2000; 84(8):914-6. PMC: 1723600. DOI: 10.1136/bjo.84.8.914. View

Day A . Aneurysms of the ophthalmic segment. A clinical and anatomical analysis. J Neurosurg. 1990; 72(5):677-91. DOI: 10.3171/jns.1990.72.5.0677. View

Mueller A, Neubauer A, Schaller U, Kampik A . Evaluation of minimally invasive therapies and rationale for a prospective randomized trial to evaluate selective intra-arterial lysis for clinically complete central retinal artery occlusion. Arch Ophthalmol. 2003; 121(10):1377-81. DOI: 10.1001/archopht.121.10.1377. View

10.

Schmidt G, Oster S, Golnik K, Tumialan L, Biousse V, Turbin R . Isolated progressive visual loss after coiling of paraclinoid aneurysms. AJNR Am J Neuroradiol. 2007; 28(10):1882-9. PMC: 8134262. DOI: 10.3174/ajnr.A0690. View

11.

Augsburger J, Magargal L . Visual prognosis following treatment of acute central retinal artery obstruction. Br J Ophthalmol. 1980; 64(12):913-7. PMC: 1042573. DOI: 10.1136/bjo.64.12.913. View

12.

Ries T, Siemonsen S, Grzyska U, Zeumer H, Fiehler J . Abciximab is a safe rescue therapy in thromboembolic events complicating cerebral aneurysm coil embolization: single center experience in 42 cases and review of the literature. Stroke. 2009; 40(5):1750-7. DOI: 10.1161/STROKEAHA.108.539197. View

13.

Sherif C, Gruber A, Dorfer C, Bavinzski G, Standhardt H, Knosp E . Ruptured carotid artery aneurysms of the ophthalmic (C6) segment: clinical and angiographic long term follow-up of a multidisciplinary management strategy. J Neurol Neurosurg Psychiatry. 2009; 80(11):1261-7. DOI: 10.1136/jnnp.2008.170860. View

14.

Heran N, Song J, Kupersmith M, Niimi Y, Namba K, Langer D . Large ophthalmic segment aneurysms with anterior optic pathway compression: assessment of anatomical and visual outcomes after endosaccular coil therapy. J Neurosurg. 2007; 106(6):968-75. DOI: 10.3171/jns.2007.106.6.968. View

15.

Ahn S, Kim J, Hong J, Woo S, Ahn J, Park K . Efficacy and safety of intra-arterial thrombolysis in central retinal artery occlusion. Invest Ophthalmol Vis Sci. 2013; 54(12):7746-55. DOI: 10.1167/iovs.13-12952. View

16.

Ahn J, Cho Y, Kang H, Kim J, Cho W, Jung S . Endovascular treatment of ophthalmic artery aneurysms: assessing balloon test occlusion and preservation of vision in coil embolization. AJNR Am J Neuroradiol. 2014; 35(11):2146-52. PMC: 7965162. DOI: 10.3174/ajnr.A3999. View

17.

Yadla S, Campbell P, Grobelny B, Jallo J, Gonzalez L, Rosenwasser R . Open and endovascular treatment of unruptured carotid-ophthalmic aneurysms: clinical and radiographic outcomes. Neurosurgery. 2011; 68(5):1434-43. DOI: 10.1227/NEU.0b013e31820b4f85. View

18.

Atebara N, Brown G, Cater J . Efficacy of anterior chamber paracentesis and Carbogen in treating acute nonarteritic central retinal artery occlusion. Ophthalmology. 1995; 102(12):2029-34; discussion 2034-5. DOI: 10.1016/s0161-6420(95)30758-0. View

19.

Rouchaud A, Leclerc O, Benayoun Y, Saleme S, Camilleri Y, DArgento F . Visual outcomes with flow-diverter stents covering the ophthalmic artery for treatment of internal carotid artery aneurysms. AJNR Am J Neuroradiol. 2014; 36(2):330-6. PMC: 7965674. DOI: 10.3174/ajnr.A4129. View

20.

Schumacher M, Schmidt D, Jurklies B, Gall C, Wanke I, Schmoor C . Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthalmology. 2010; 117(7):1367-75.e1. DOI: 10.1016/j.ophtha.2010.03.061. View