June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Retinal Artery Occlusion after Intravascular Procedure: Case Series and Literature Review
Author Affiliations & Notes
  • Soo Chang Cho
    Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  • Cheolkyu Jung
    Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  • Joo Yong Lee
    Asan Medical Center, Seoul, Korea (the Republic of)
  • Sang Jin Kim
    Samsung Medical Center, Seoul, Korea (the Republic of)
  • Kyu Hyung Park
    Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  • Na-Kyung Ryoo
    Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  • Se Joon Woo
    Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  • Footnotes
    Commercial Relationships   Soo Chang Cho, None; Cheolkyu Jung, None; Joo Yong Lee, None; Sang Jin Kim, None; Kyu Hyung Park, None; Na-Kyung Ryoo, None; Se Joon Woo, None
  • Footnotes
    Support  National Research Foundation of Korea (NRF) grant 2016R1D1A1B03934724
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3650. doi:
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      Soo Chang Cho, Cheolkyu Jung, Joo Yong Lee, Sang Jin Kim, Kyu Hyung Park, Na-Kyung Ryoo, Se Joon Woo; Retinal Artery Occlusion after Intravascular Procedure: Case Series and Literature Review. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3650.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : This study presented clinical characteristics of retinal artery occlusion after intravascular procedure and investigated possible mechanisms.

Methods : This study is a meta-analysis of retrospective case series including 10 new patients with acute RAO following intravascular procedure and previous case reports of 17 cases of RAO associated with intravascular procedures. Demographic and clinical characteristics of patients from current series and previous reports were presented. Total 27 cases of RAO were categorized into two groups according to assumed etiology; group 1 (dislodged emboli): RAO as a result of emboli from dislodged plaque fragments following procedural manipulation, group 2 (new emboli): RAO as a result of emboli from a newly formed thrombus or from the embolic material used, during the procedure.

Results : Of 27 cases, 17 (63.0%) patients had branch retinal artery occlusion and 10 (37.0%) patients central retinal artery occlusion. Proportion of patients with final BCVA ≥ 20/40 was 61.1%. The anatomical regions of the intravascular procedure were carotid artery (48.1%), heart (25.9%), carotid artery or heart (3.7%), brain (11.1%), scalp/glabellar (7.4%), and thyroid (3.7%). 16 cases were categorized as group 1 and 11 cases were categorized as group 2. Cases of group 1 were related with the dislodged plaque from carotid artery (9 cases, 56.3%) heart (6 cases, 37.5%), or carotid artery/heart (1 case, 6.3%; case with transfermoal cerebral angiography and coronary angiography). Cases of group 2 were related with newly formed thrombi (6 cases, 54.5%) or migrated embolic material via collateral channels between external carotid and ophthalmic arteries (5 cases, 45.5%). 17 (63.0%) patients presented with acute visual disturbance immediately after the procedures, 10 (37.0%) patients showed delayed occurrence (1 day to 3 days after procedure).

Conclusions : In conclusion, retinal artery occlusion can be a complication following intravascular procedures by a dislodged embolic plaque from carotid artery or heart, or by a newly formed thrombus or embolic material via collateral channels. BRAO was presented more often than CRAO after intravascular procedure. RAO with delayed onset can be complicated after intravascular procedure. Therefore, patients should be informed about the possible delayed presentation of RAO, and cautious ophthalmic examination is recommended till a few days after the procedure.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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