RETINAL ISCHEMIA AND HEMORRHAGES AFTER EMBOLIZATION OF INTRACRANIAL ANEURYSMS: A CASE SERIES

PURPOSE: To describe retinal changes that can be associated with embolization of intracranial aneurysms. METHODS: Retrospective case series of four patients. Standard ophthalmic exams were performed along with color fundus photographs, high-resolution optical coherence tomography, and fluorescein angiography. RESULTS: Four patients underwent interventional therapy to close intracranial vascular aneurysms. The four patients ranged from 31 years to 78 years of age. Three were female while one was male. All were diagnosed with symptomatic cerebral aneurysms that were treated by embolization. All described visual symptoms immediately following interventional procedures. Retinal hemorrhages and ischemia were found in all patients during complete ophthalmologic evaluation. Multimodal imaging was carried out and documented evidence of various vascular changes such as retinal hemorrhages and vascular occlusion ranging from cotton wool spots to a cilioretinal artery occlusion. CONCLUSIONS: Retinal ischemia and hemorrhages are complications of ophthalmic and communicating segment aneurysm embolization, and while our series of patients were all symptomatic, peripheral asymptomatic lesions may also occur. We believe that patients and providers should be aware of these potential sight-threatening complications.