Partial Retinal Artery Occlusion after Coil Embolization of an Intracerebral Aneurysm

Abstract

Occlusion of the retinal artery is a rare complication after therapeutic embolization. We present a case of a partial retinal artery obstruction following coil embolization of an intracerebral aneurysm. To our knowledge, only six cases of acute occlusion of the choroidal and/or retinal arteries after therapeutic embolization have been reported so far. The case presented here, however, is the first in which platinum microcoils were the material used. In addition the retinal ischemia was reversible, visual acuity returning to normal and cutten-wool spot and retinal hemorrhages resolving spontaneously.

Multiple small branch retinal arteriolar occlusions following coil embolization of an internal carotid artery aneurysm

“…To the best of our knowledge, there have been only four cases of branch retinal artery occlusion following coil embolization of intracranial aneurysms. [ 3 4 5 ] In contrast to previous cases, multiple small arteriolar obstructions sparing the fovea center were found in our case. In addition, incomplete reperfusion was found on fluorescein angiography even after 6 months of the first event.…”

“…[ 2 ] However, it has been reported that this technique carries the risk of ophthalmologic complications. [ 3 4 5 ] Herein, we report a case of multiple small retinal arteriolar occlusions following coil embolization.…”

A Case of Purtscher Retinopathy Associated with Stent-Assisted Coil Embolization of a Middle Cerebral Artery Aneurysm

“…However, the relationship between retinal artery obstruction and Purtscher retinopathy is unclear because retinal findings including cotton-wool spots, retinal hemorrhage, and optic disc swelling are not specific signs (1, 2). Ascaso and Cristóbal (7) reported a case of partial retinal artery obstruction, and the fundus findings and the history of the patients were similar to clinical symptoms of Purtscher retinopathy. Therefore, Purtscher retinopathy could have been described clinically as a minor form or partial obstruction of retinal arterial circulation in previous reports.…”

Intra-arterial Thrombolysis for Central Retinal Artery Occlusion after the Coil Embolization of Paraclinoid Aneurysm

“…In our review, it was extremely rare that emboli or thrombi from coil embolization of ICA aneurysms caused CRAO ( Table 1 ). 1) 2) 3) 4) 5) 6) In the described case, the inadvertent insertion of the microcatheter or microwire into the orifice of the ophthalmic artery might have caused endothelial injury. Despite the continuous flushing of the catheter and systemic heparization, this injury most likely affected thrombus formation near the injured orifice of the ophthalmic artery, resulting in embolic occlusion of the retinal artery.…”