J Korean Ophthalmol Soc.  2020 Sep;61(9):1104-1108. 10.3341/jkos.2020.61.9.1104.

Orbital Infarction Syndrome after Thrombectomy for Internal Carotid Artery Occlusion

• Lee D
• Kim WJ
• Kim MM

• KMID: 2506488
• DOI: http://doi.org/10.3341/jkos.2020.61.9.1104

Abstract

Purpose
To report a case of orbital infarction syndrome after thrombectomy for internal carotid artery (ICA) occlusion.
Case summary
A 69-year-old female with a history of diabetes mellitus and hypertension was referred to our clinic because of acute right ocular pain and visual disturbance. The patient had a history of a right middle cerebral artery territory infarction following right ICA occlusion and her ocular symptoms developed 6 hours after thrombectomy treatment. The visual acuity was hand motion in the right eye and 20/20 in the left eye. Pupil dilation and a relative afferent pupillary defect were seen in her right eye. There was ptosis of the right eyelid, and the ocular motility examination showed all gaze limitations in the right eye. In fundus examinations, multiple white focal ischemic retinal lesions were observed in the right eye suggesting branch retinal artery occlusion. Slit lamp examination showed chemosis in the right eye. The patient was diagnosed with ocular infarction syndrome due to micro-thromboembolism of the ophthalmic artery which developed after the thrombectomy.
Conclusions
Orbital infarction syndrome can occur after thrombectomy. Therefore, it is necessary to consider the development of orbital infarction when patients present with sudden-onset ocular pain, visual loss, and ocular movement limitations after the procedure.

Keyword

Ophthalmoplegia; Orbital infarction syndrome; Thrombectomy