Vascular Steal Syndrome, Optic Neuropathy, and Foreign Body Granuloma Reaction to Onyx-18 Embolization for Congenital Orbito-Facial Vascular Malformation

Catherine Y. Liu, Marc A. Yonkers, Tiffany Liu, Don S. Minckler, Jeremiah P. Tao

Research output: Contribution to journalArticle

Abstract

A 34-year-old patient presented with a right orbito-facial mass since childhood, consistent with a congenital arteriovenous (AV) malformation. Prior to presentation, she had multiple incomplete surgical resections and embolizations with N-butyl acetyl acrylate and Onyx-18. The patient reported gradual, progressive vision loss shortly after Onyx-18 embolization. Five months after embolization, she presented with decreased vision, disfigurement and mechanical ptosis relating to a large subcutaneous mass affecting the medial right upper eyelid and forehead. Significant exam findings included a visual acuity of 20/400 (20/60 prior to embolization), an afferent pupillary defect, and optic disc pallor. MRI and angiography revealed a persistent AV malformation with feeders from the ophthalmic artery and an absent choroidal flush to the right eye. Pathology from surgical resection showed a significant foreign body giant cell reaction to the embolization material adjacent to the vessels. We suggest that an incomplete embolization with Onyx-18 may have caused vascular steal syndrome from the ophthalmic artery.

Original languageEnglish (US)
Pages (from-to)185-189
Number of pages5
JournalOcular Oncology and Pathology
Volume2
Issue number3
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Foreign-Body Granuloma
Foreign-Body Reaction
Optic Nerve Diseases
Vascular Malformations
Ophthalmic Artery
Blood Vessels
Arteriovenous Malformations
Foreign Body Giant Cells
Pupil Disorders
Pallor
Surgical Pathology
Forehead
Magnetic Resonance Angiography
Optic Disk
Eyelids
Visual Acuity
Onyx 18

Keywords

  • Embolization
  • Ptosis
  • Vascular lesion

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Vascular Steal Syndrome, Optic Neuropathy, and Foreign Body Granuloma Reaction to Onyx-18 Embolization for Congenital Orbito-Facial Vascular Malformation. / Liu, Catherine Y.; Yonkers, Marc A.; Liu, Tiffany; Minckler, Don S.; Tao, Jeremiah P.

In: Ocular Oncology and Pathology, Vol. 2, No. 3, 01.04.2016, p. 185-189.

Research output: Contribution to journalArticle

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