Ophthalmic Artery Occlusion Research Articles

Fundus artery occlusion caused by cosmetic facial injections

Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections. Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity (BCVA), fundus fluorescein angiography, and associated ocular and systemic manifestations. Results Eleven patients had ophthalmic artery occlusion (OAO) and one patient each had central retinal artery occlusion (CRAO) and anterior ischemic optic neuropathy (AION). Injected materials included autologous fat (seven cases), hyaluronic acid (five cases), and bone collagen (one case). Injection sites were the frontal area (five cases), periocular area (two cases), temple area (two cases), and nose area and nasal area (4 cases). Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA. Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid injection.

Experimental model of ocular ischemic diseases

The review presents the most common methods of modeling of retinal ischemia in vitro (chemical ischemia with iodoacetic acid, incubation of the retinal pigment epithelium cells with oligomycin, deprivation of oxygen and glucose) and in vivo (a model with increased intraocular pressure, cerebral artery occlusion, chronic ligation of the carotid arteries, photocoagulation of the retinal vessels, occlusion of the central retinal artery, endothelin-1 administration). Modeling ischemic injury in rats is the most frequently used method in studies, because the blood supply of their eyes is similar to blood flow in the human eyes. Each method has its own advantages and disadvantages. Application of methods depends on the purpose of the experimental study. Currently model of ocular ischemic disease can be obtained easily by injecting vasoconstrictive drug endothelin-1. It is the most widely used method of high intraocular pressure induced ocular ischemic damage similar to glaucoma, occlusion of central retinal artery or ophthalmic artery in human. The development of experimental models of ocular ischemic diseases and detailed investigation of mechanisms of impairment of microcirculation are useful for improve the efficiency of diagnostic and treatment of ischemic diseases of retina and optic nerve.

A Case of Suspected Bilateral Ophthalmic Artery Occlusion, Spinal Cord Infarction, and Agranulocytosis in a Cocaine User (P07.234)

A Case of Suspected Bilateral Ophthalmic Artery Occlusion, Spinal Cord Infarction, and Agranulocytosis in a Cocaine User (P07.234)

Rhino-orbito-cerebral mucormycosis complicated with an ophthalmic artery occlusion followed by subarachnoid hemorrhage

A 70-year-old female with poorly controlled diabetes developed sudden visual loss, ptosis and complete ophthalmoplegia of the right eye. Funduscopic examination showed the pale retina and the cherry red spot in the right eye. Fluorescein angiography and indocyanine green angiography demonstrated the absence of retinal arterial filling and choroidal perfusion in the right eye even 20 minutes after injecting the dye. The patient was diagnosed with right ophthalmic artery occlusion. Computed tomography (CT) showed diffuse mucosal thickening in the right ethmoidal sinus. Based on the clinical findings and endoscopic biopsy result, mucormycosis was confirmed. Amphotericin B (40 mg/day) and ceftriaxone (2 g/day) were intravenously administered. Despite the improvement of the right ethmoidal sinusitis and the right proptosis, the patient deteriorated into a comatose state after 19 days of systemic amphotericin B therapy. Although the previous CT showed no cerebral aneurysm, a repeated CT showed newly developed posterior communicating artery aneurysm and the subarachnoid hemorrhage. Despite the amphotericin B treatment and the improvement of the sinusitis, mucormycosis could cause sudden cerebral aneurysm rupture and subarachnoid hemorrhage resulting in coma.

Ophthalmic Artery Occlusion Secondary to Fat Emboli After Cosmetic Nasal Injection of Autologous Fat

Ophthalmic Artery Occlusion Secondary to Fat Emboli After Cosmetic Nasal Injection of Autologous Fat

Orbital Infarction Syndrome After Transcanalicular Dacryocystorhinostomy With Diode Laser

Orbital infarction syndrome is a rare but devastating disorder resulting in sudden visual loss. A patient with orbital infarction syndrome due to orbital cellulitis after transcanalicular dacryocystorhinostomy with diode laser is described. A 55-year-old woman presented 3 days after transcanalicular dacryocystorhinostomy. Initial examination revealed significant eyelid swelling, marked proptosis, total ophthalmoplegia, and no light perception in the right eye. Fundus examination revealed ophthalmic artery occlusion. The clinical findings of the patient were consistent with orbital infarction syndrome. Clinical findings improved with antibiotic therapy, but visual acuity did not change.

Iatrogenic Retinal Artery Occlusion Caused by Cosmetic Facial Filler Injections

To investigate the clinical manifestations and visual prognosis of retinal artery occlusion resulting from cosmetic facial filler injections. Retrospective, noncomparative case series. Setting. Institutional. Study Population. Twelve consecutive patients with retinal artery occlusion caused by cosmetic facial filler injections. Main Outcome Measures. Filler materials, injection sites, best-corrected visual acuities, fundus fluorescein angiography and optical coherence tomography findings, and associated ocular and systemic manifestations. Seven, 2, and 3 patients had ophthalmic, central retinal, and branch retinal artery occlusions, respectively. Injected materials included autologous fat (7 cases), hyaluronic acid (4 cases), and collagen (1 case), and injection sites were the glabellar region (7 cases), nasolabial fold (4 cases), or both (1 case). Injected autologous fat was associated with worse final best-corrected visual acuity than the other materials. All patients with ophthalmic artery occlusion had ocular pain and no improvement in best-corrected visual acuity. Optical coherence tomography revealed thinner and less vascular choroids in eyes with ophthalmic artery occlusion than in adjacent normal eyes. Concomitant brain infarction developed in 2 cases each of central retinal artery occlusion and ophthalmic artery occlusion. Phthisis developed in 1 case of ophthalmic artery occlusion. Cosmetic filler injections into the glabellar region or nasolabial fold can cause retinal artery occlusion. Iatrogenic ophthalmic artery occlusion is associated with painful blindness, a thin choroid, brain infarction, and poor visual outcomes, particularly when autologous fat is used. Ophthalmic examination and systematic brain magnetic resonance imaging should be performed in patients with ocular pain after such injections.

Aspects évolutifs de la rétine en coupe OCT spectral domain lors des oblitérations artérielles rétiniennes

Retinal artery occlusions are a straightforward, essentially clinical diagnosis. The role of spectral domain ocular coherence tomography (SD-OCT) in this condition is not well described. Anoxic retinal edema develops in the acute phase of retinal artery occlusion (RAO) followed by a regressive phase giving way to retinal atrophy. The purpose of the study was to determine dynamics of theses retinal changes in central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO) using spectral domain optical coherence tomography (SD-OCT). A prospective study of patients hospitalized at Hôpital Edouard-Herriot de Lyon between June and September 2009 was performed after patient education and informed consent. Retinal thickness of patients with central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or cilio-retinal artery occlusion was measured centered on the macula or on the site of occlusion with spectral domain optical coherence tomography (SD-OCT) using Cirrus(®) (Carl Zeiss Meditec, Germany) upon admission, throughout hospitalization, at 1 month and at 3 months. Thickness and reflectivity of the various retinal layers were compared with the fellow eye. Fourteen patients were included (seven CRAO, six BRAO and one cilio-retinal artery occlusion). SD-OCT in the acute phase showed retinal thickening and increased reflectivity confined to the inner retinal layers supplied by the retinal circulation with decreased reflectivity from the photoreceptor and retinal pigment epithelial layers secondary to a shadowing effect in the affected area. These changes subsequently resolved at 1 month and gave way to a marked thinning of the inner retinal layers by 3 months. In one case of CRAO associated with an ophthalmic artery occlusion and consequent occlusion of the ciliary circulation as well, initial OCT revealed complete retinal thickening involving both the inner and outer layers. This study demonstrates that the anoxic intracellular edema resulting from retinal artery occlusions (RAO) observed histologically appears on OCT as a thickening of the inner retinal layers in the acute stage of the condition, giving way to atrophic areas starting at approximately 1 month ("pseudonormalization") and becoming clearly atrophic at 3 months. SD-OCT is useful in the diagnosis of RAO, especially if the patient is seen later in the disease process, when the ischemic retinal whitening is no longer present on fundus exam.

P-012 Continued concern of parent vessel steno-occlusive progression with Onyx HD-500 and the utility of quantitative MRI in serial assessment

IntroductionOnyx HD-500 is an alternative endovascular treatment in selected cerebral aneurysms that offers advantages over standard coiling or stent assisted coiling in that complete occlusion of the aneurysm can be...

Partial Recovery after Intraarterial Pharmacomechanical Thrombolysis in Ophthalmic Artery Occlusion following Nasal Autologous Fat Injection

Although autologous fat injection into the face is a widely used procedure in aesthetic surgery, heed must be taken because it may cause severe complications related to inadvertent arterial embolization, including stroke and vision loss. Vision loss may originate from ophthalmic artery occlusion, and no therapeutic options have yet been reported for this condition. Herein, the authors report a case of ophthalmic artery occlusion following nasal autologous fat injection. Partial recovery of choroidal and retinal perfusion, ocular motility, and corneal clarity was achieved after intraarterial pharmacomechanical thrombolysis.

MRI Restricted Diffusion in Optic Nerve Infarction After Autologous Fat Transplantation

A 24-year-old woman reported blindness in the left eye upon awakening from fat autotransplantation to her forehead for soft tissue augmentation in the face. Clinical findings on the third postoperative day suggested ipsilateral ophthalmic artery occlusion with infarction of the optic nerve and retina. There were also clinical manifestations of a mild right hemiparesis. MRI diffusion-weighted imaging (DWI) revealed restricted diffusion of the left optic nerve and left middle cerebral artery domain indicative of the cytotoxic edema of infarction. This is the second report of optic nerve infarction after fat autotransplantation to the forehead and the first report of DWI restricted diffusion in this setting.

Unusual visual loss after snakebite

Snakebites are endemic in some parts of Thailand, being associated with several complications. Ocular disturbances are uncommon, except in cases of corneal or conjunctival injury, when the eye is directly exposed to the snake venom. The present study presents a case of combined ophthalmic artery occlusion and transient central retinal artery occlusion with macular ischemia after a Russell's viper bite.

Spontaneous recanalization of the internal carotid artery resulting in thromboembolic occlusion of the ipsilateral ophthalmic artery and visual loss

We report a 54-year-old man who suffered a stroke from a complete right internal carotid artery (ICA) occlusion. Two months later, he presented with right eye blindness. Imaging demonstrated 50% recanalization of his right ICA. He underwent a right carotid endarterectomy to prevent contralateral stroke from emboli through a patent anterior communicating artery. Recanalization of a completely occluded proximal ICA due to atherosclerotic disease has been reported but is rare, but such patients emphasize the importance of follow-up vascular studies.

Restricted Diffusion in the Optic Nerve and Retina Demonstrated by MRI in Rhino-Orbital Mucormycosis

A 29-year-old man developed vision loss in the right eye due to ophthalmic artery, cavernous sinus, and superior ophthalmic vein occlusion in mucormycosis. Diffusion MRI obtained within 2 days of symptom onset showed that the apparent diffusion coefficient values of the optic nerve and retina were remarkably decreased on the affected compared with the unaffected side. A follow-up MRI study 21 days after symptom onset revealed the anticipated disappearance of these signal changes, confirming that they were a true reflection of ischemia in the optic nerve and retina. This report adds to an accumulating body of literature on restricted diffusion in these tissues in conditions producing severe ischemia.

An Incidental Finding of Pseudoexfoliation in Patient With Ophthalmic Artery Occlusion

Purpose: To report a case of pseudoexfoliation in the unaffected eye in a patient with ophthalmic artery occlusion. Case summary: A 49-year-old female presented with sudden vision loss in her right eye. On the initial examination, best corrected visual acuity was 20/500 in the right eye, and 20/20 in the left eye. Intraocular pressure in both eyes was 17 mmHg. Fundus examination showed retinal edema and a cotton wool spot in the right eye. There was a filling delay of choroidal and retinal vessels in the fluorescein angiography. On the slit lamp examination, there was pseudoexfoliation material around the pupil margin and lens capsule in the unaffected eye but no evidence of glaucoma. At the six-month follow-up, best corrected visual acuity in the right eye improved to 20/30 and a retinal nerve fiber layer defect was found at the spot of the previous cotton wool spot. On the visual field examination, visual defects corresponded with a retinal nerve fiber layer defect. Conclusions: Pseudoexfoliation may be related to a systemic vascular disorder.

Ophthalmic Artery Occlusion With Third Cranial Nerve Paresis Associated With Acute Internal Carotid Artery Occlusion

Purpose: We report a case of ophthalmic artery occlusion with third nerve paresis in the left eye due to acute occlusion of the left ICA. Case summary: A 37-year-old man visited our emergency room with black out in the left eye, headache, and nausea. The corrected visual acuity was 20/25 in the right eye, and hand motion in the left eye. In the left eye, a relative afferent papillary defect was noted, with an intraocular pressure of six mmHg. Twenty prisms of exotropia in the primary position was observed, and ocular motor examination revealed limitations of supraduction, infraduction, and adduction in the left eye, suggesting third nerve palsy of the left eye. Fundus examination revealed a pale retina in the macula of the left eye. Brain MRI demonstrated multifocal faint low densities in the left caudate nucleus as well as the frontal and parietal lobes. CT angiography and four-vessel angiography demonstrated complete occlusion in the proximal part of the left internal carotid artery ICA. After five months the corrected visual acuity of the left eye improved to 20/200. The 20 prism diopters of exotropia persisted, and ocular motor examination revealed only a mild limitation of adduction in the left eye.

Ophthalmic artery occlusion in relapsing polychondritis.

To describe ophthalmic artery occlusion in a patient with relapsing polychondritis. Observational case report : An acute episode of relapsing polychondritis caused ophthalmic artery occlusion with resultant visual acuity of no light perception. Ophthalmic artery occlusion can occur in patients with relapsing polychondritis. Patients with relapsing polychondritis need close follow-up to exclude severe vascular disease.

Fusiform Intracanalicular Ophthalmic Artery Aneurysm; Case Report and Review of Literature

A 35-year-old man's vision had progressively deteriorated over a 3-month period. His left visual acuity was 5/20. Enhanced orbital computed tomographic (CT) scans revealed a fusiform dilatation of the ophthalmic artery in the left optic canal. Cerebral Angiography revealed a fusiform aneurysm on the left ophthalmic artery in the optic canal, measuring 6.2 x 4.6 mm in size. Four days after admission, visual acuity dropped to hand-motion. Endovascular treatment was chosen and a microcatheter was guided into the proximal segment of the ophthalmic artery. Using 4 detachable coils, parent artery occlusion was done. Three months after the intervention, the visual acuity in his left eye improved to 20/20. Dramatic recovery of visual acuity is exceptional with an ophthalmic artery trunk aneurysm. When an occlusion of the proximal ophthalmic artery is the only treatment option in such a situation, the endovascular occlusion of the proximal ophthalmic artery is quite feasible in the sense that it does not require any optic nerve manipulation.

Bilateral Ophthalmic Artery Occlusion in Rhino-Orbito-Cerebral Mucormycosis

PurposeTo report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis.MethodsReviewed clinical charts, photographs, and fluorescein angiography.ResultsAn 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission.ConclusionsBilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.

Lobular Structure of the Choriocapillaris in a Patient with Ophthalmic Artery Occlusion

Lobular Structure of the Choriocapillaris in a Patient with Ophthalmic Artery Occlusion