Central retinal artery occlusion following embolization in juvenile nasopharyngeal angiofibroma – A case report

Jelica Pantelić; Jelena Karadžić; Igor Kovačević; Jelena Bulatović

doi:10.2298/VSP160620388P

Jelica Pantelić Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
Jelena Karadžić Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
Igor Kovačević Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
Jelena Bulatović General Hospital, Pljevlja, Montenegro

DOI: https://doi.org/10.2298/VSP160620388P

Keywords: nasopharyngeal neoplasms;, angiofibroma;, child;, diagnosis;, embolization, therapeutic;, otorhinola¬ryngologic surgical procedures;, neoplasm recurrence, local;, retinal artery occlusion;, treatment outcome.

Abstract

Introduction. Juvenile nasopharyngeal angiofibromas are highly vascular, locally aggressive lesions, that affect male adolescents. The surgery is the treatment of choice, although it shows a strong propensity to bleed during surgical removal. Preoperative embolization enables the surgical approach in a less bloody way and also a complete resection of the tumor. However, this procedure is not without complications. The most severe complication of this technique is a migration of an embolus into the intracranial circulation. Case report. We present a 9-year-old boy who lost vison on his left eye following preoperative embolisation of juvenile nasopharyngeal angiofibromas as a result of central retinal artery occlusion. A recent review of the literature reported only three previously documented cases of central retinal artery occlusion occurring after embolization for a nasopharyngeal angiofibroma. We want to point out the possibility of this rare but devastating complication and the importance of rapid and accurate diagnosis and treatment so that a visual outcome could be better when applying an early medical treatment. Conclusion. Described case of central retinal artery occlusion is a rare and unusual, iatrogenic vascular event, that could arise as a complication from embolisation of nasopharingeal tumors. However, physicians (ophthalmologists and ear-nose-throat surgeons) should be aware od this devastating complication, and the close evaluation of angiograms for detection of any vascular abnormality before and during the embolization is crucial.

Author Biography

Jelena Karadžić, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia

Department of Medical retina and neuro-ophthalmology

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