Open AccessCentral retinal artery occlusion combined with posterior ciliary artery occlusion after preoperative embolization of the middle meningeal artery for intracranial meningioma
Author(s) -
Kathy Ming Feng,
Chang-Min Liang,
Shu-I Pao
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000021197
Subject(s) - medicine , middle meningeal artery , ophthalmic artery , central retinal artery occlusion , embolization , ciliary arteries , central retinal artery , occlusion , fundus (uterus) , retinal artery occlusion , surgery , ophthalmology , visual acuity , radiology , retinal , blood flow
Rationale: Preoperative embolization of brain tumors has been widely used to minimize hemorrhaging during surgery, but anastomosis between vessels is sometimes overlooked and complications can occur. Herein we describe a case of rare complications of central retinal artery occlusion (CRAO) and posterior ciliary artery occlusion after embolization of the middle meningeal artery. Patient concerns: A 48-year-old woman experienced acute, painless loss of vision in her left eye during embolization of the middle meningeal artery for meningioma. Diagnosis: The patient was diagnosed with CRAO and posterior ciliary artery occlusion based on indirect ophthalmoscopy, optical computed tomography of the macula, and fundus angiography. Interventions: Ocular massage, oral acetazolamide, and topical brimonidine eyedrops were administered. Outcomes: Visual acuity decreased from hand motion to no light perception within 2 months. Optic disc atrophy with retinal thinning was evident after 2 to 4 months. Lessons: The blood supply and any collateral vessels of the ophthalmic artery should be vigilantly scrutinized to prevent complications during embolization of the middle meningeal artery that may lead to a poor visual outcome.