Title | Two cases of embolisation of the ophthalmic circulation |
Abstract Nr. | A1010 |
Purpose | To present two cases with embolisation to the arterial ophthalmic circulation after non-ophthalmic surgery in the facial area. |
Methods | Case 1 A 48-year-old female suffered from a facial trauma, resulting in a fistula with loss of cerebrospinal fluid. The fistula persisted despite multiple surgeries. A final attempt to close the fistula and to restore her facial features with fat injection, resulted in a left sided hemiparesis and blindness of the right eye. Clinical work-up included cerebral MR scans, slit lamp examination and fluoro-angiography. Case 2 A male patient of 47 years received a sclerotizing injection in the nasal cavity, resulting in a visual loss of his left eye. Clinical work-up included slit lamp examination. Additionally, fluoro-angiography and measurement of visually evoked potentials (VEP) were performed. |
Results | Case 1 On slit lamp examination posterior synechiae were demonstrated. Fluoro-angiography showed the consequences from occlusion of the retinal and choroidal circulation of the right eye. Imaging studies showed a cerebrovascular accident, most likely emboligenic in origin. Retrograde embolisation of the injected fat tissue was suspected via the internal carotid artery with occlusion of the ophthalmic artery. Case 2 Ophthalmic examination revealed an occlusion of the retinal central artery, caused by embolisation of the sclerotizing agent. Eye fundus examination revealed a cherry red spot. The VEP-responses of the left eye were severely disturbed. |
Conclusion | Surgery in the facial area is not without ophthalmic risks as embolisation of the ophthalmic artery may occur, resulting in blindness of the corresponding eye. |
Last name | VAN LINT |
Initials | M |
Department | Dept of Ophthalmology, Ghent University Hospital |
City | Ghent, Belgium |
Last name | KESTELYN |
Initials | PH |
Last name | DE LAEY |
Initials | JJ |