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- W2567482792 abstract "management of tumors. The use of liquid embolic agents, embolic microparticles or coils to devascularize the tumor bed facilitates safer surgical resection of the tumor itself [1]. However, this procedure carries the risk of neurological deficit, visual loss and severe disability. Branch retinal artery occlusion [2] and cilioretinal artery occlusion [3] have been reported following embolization of intracranial meningioma. Here, we report two cases of iatrogenic retinal artery occlusions occurring after embolization of intracranial tumor feeder arteries with occlusive agents. Retinal artery occlusion is an ocular emergency that is associated with profound morbidity. Case 1 A 23 year old gentleman who has an extensive right temporal lobe haemangiopericytoma involving the skull bone had selective catheterization and embolization of the tumor feeder artery with a liquid embolic agent (Onyx ® ) to reduce blood flow in the tumor bed prior to an elective surgical debulking procedure. He experienced transient visual obscurations immediately after the procedure and was arranged to be seen by an ophthalmologist at the Eye Clinic. The Snellen visual acuity of each eye was 20/20. While in the waiting room, he developed a sudden deterioration of vision to hand movements only in his right eye. There was a dense relative afferent pupillary defect and a diagnosis of a central retinal artery occlusion (CRAO) was made. This completely resolved after 15 minutes with complete restoration of his vision. Unfortunately, a second episode of CRAO occurred 15 minutes later and his right vision deteriorated to no perception of light. Immediate interventions such as ocular massage, anterior chamber paracentesis, topical beta-blocker and intravenous acetazolamide to improve retinal artery circulation failed to reverse the CRAO. An emergency cerebral angiogram was performed. Although the right ophthalmic artery was patent, his vision remained unchanged. Hence, only a very small dose of intra-arterial fibrinolysis with 10 mg of alteplase (recombinant tissue plasminogen activator) was administered into the right ophthalmic artery. His right vision improved to hand movement the following day. As visualized in Figure 1A, embolic particles are observed in retinal arteries on ophthalmoscopy. Case 2" @default.
- W2567482792 created "2017-01-06" @default.
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- W2567482792 date "2013-01-01" @default.
- W2567482792 modified "2023-09-26" @default.
- W2567482792 title "Retinal Artery Occlusion after Embolization of Intracranial Tumor Embolization plays an important role as an adjunct to the surgical" @default.
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