doiSerbia

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

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

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.

Keywords: nasopharyngeal neoplasms, angiofibroma, child, diagnosis, embolization, therapeutic, otorhinolaryngologic surgical procedures, neoplasm recurrence, local, retinal artery occlusion, treatment outcome