The Problem of Connection: A Case of Ophthalmic Artery Occlusion Following Middle Meningeal Artery Embolization

PURPOSE: To describe a case of an iatrogenic ophthalmic artery occlusion following middle meningeal artery (MMA) embolization. METHODS: Clinical data was collected through a retrospective review of the patient's medical records, imaging studies, and procedural reports. The patient was evaluated and managed according to standard clinical protocols. The case was documented in accordance with institutional guidelines for case reporting. RESULTS: An 83-year-old woman developed right-eye vision loss following right MMA embolization for subdural hemorrhage. Imaging showed embolic material in the ophthalmic artery and ciliary branches. Exam revealed no light perception and fundus findings consistent with ophthalmic artery occlusion. Two weeks later, vision improved to hand motion, with embolic material visible in retinal arterioles and signs of an incomplete or partially recanalized ophthalmic artery occlusion. CONCLUSION: This case highlights a serious complication following MMA embolization and supports consideration of coiling as an alternative for chronic subdural hematomas. Although the overall incidence is low, vision loss from arterial occlusion during intracranial embolization procedures can be sudden, severe and permanent. It is therefore reasonable to consider developing both protocols and procedural techniques to further reduce the risk of post-embolization occlusions.