Ophthalmological complications after treatment of carotid-ophtalmic artery aneurysms using flow diverter

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Abstract

Purpose

To evaluate the ocular complications after insertion of a flow diverter “ pipeline embolization device” (PED) to treat carotid-ophtalmic artery aneurysms. PED is an endovascular implant designed as a stent to alter blood flow into the aneurysm. Therefore it may decrease the blood flow in the ophtalmic artery, and induce ophtalmological complications.

Methods

22 patients suffering from carotid-ophtalmic artery aneurysm, treated by flow diverter were included. Every patient underwent retrospectively a complete ophtalmological examination including macular and optic disc OCT and visual field.

Results

Among those 22 patients, 12 (54%) reported fonctional troubles: decreased visual acuity (6 patients), visual field loss (1), diplopia (1), amaurosis (1), photopsia or myodesopsia (3). 5 (23%) had clinical lesions: optic atrophy (3), distal embolism (2). No patient presented optic nerve compression after embolization as checked on MRI.

Conclusion

After flow divertion insertion, ophtalmological complications are frequent and various. Ophtalmological complications are rather due to ischaemia than compression, and may lead to optic atrophy and loss of vision. However a majority of patients recover normal visual function

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