Iatrogenic ophthalmic artery occlusion and retinal artery occlusion

Jong Suk Lee; Jun Yup Kim; Cheolkyu Jung; Se Joon Woo

doi:10.1016/j.preteyeres.2020.100848

Iatrogenic ophthalmic artery occlusion and retinal artery occlusion

Prog Retin Eye Res. 2020 Mar 10:100848. doi: 10.1016/j.preteyeres.2020.100848. Online ahead of print.

Authors

Jong Suk Lee¹, Jun Yup Kim², Cheolkyu Jung³, Se Joon Woo⁴

Affiliations

¹ Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
² Department of Neurology, Seoul National University College of Medicine, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
³ Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
⁴ Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: sejoon1@snu.ac.kr.

PMID: 32165219
DOI: 10.1016/j.preteyeres.2020.100848

Abstract

Iatrogenic ophthalmic artery occlusion (IOAO) is a rare but devastating ophthalmic disease that may cause sudden and permanent visual loss. Understanding the possible etiologic modalities and pathogenic mechanisms of IOAO may prevent its occurrence. There are numerous medical etiologies of IOAO, including cosmetic facial filler injection, intravascular procedures, intravitreal gas or drug injection, retrobulbar anesthesia, intraarterial chemotherapy in retinoblastoma. Non-ocular surgeries and vascular events in arteries that are not directly associated with the ophthalmic artery, can also cause IOAO. Since IOAO has a limited number of treatment modalities, which lead to poor final visual prognosis, it is imperative to acknowledge the information regarding medical procedures that are etiologically associated with IOAO. We accumulated all searchable and available IOAO case reports (our cases and previous reported cases from the literature), classified them according to their mechanisms of pathogenesis, and summarized treatment options and responses of each of the causes. Various sporadic cases of IOAO can be categorized into three mechanisms as follows: intravascular event, orbital compartment syndrome, and increased intraocular pressure. Embolic IOAO, which is considered the primary cause of the condition, was classified into three subgroups according to the pathway of embolic movement (retrograde pathway, anterograde pathway, pathway through collateral channels). Despite the practical limitations of treating spontaneous (non-iatrogenic) retinal artery occlusion, this article will contribute in predicting and improving the prognosis of IOAO by recognizing the treatable factors. Furthermore, it is expected to provide clues to future research associated with the treatment of retinal artery occlusion.

Keywords: Compartment syndromes; Dermal fillers; Endovascular procedures; Iatrogenic disease; Intraocular pressure; Ophthalmic artery occlusion; Retinal artery occlusion.

Publication types

Review