Ocular infarction following ethanol sclerotherapy of an arteriovenous malformation

Abstract

Purpose: To illustrate a case of ocular infarction following percutaneous ethanol sclerotherapy of an orbital arteriovenous malformation. Observations: The patient is a 31-year-old female who developed ocular infarction of the left eye with light perception vision, proptosis, ophthalmoplegia, and a cherry red spot following sclerotherapy of an orbital arteriovenous malformation. Fluorescein angiography demonstrated decreased arteriolar filling with vascular leakage, indocyanine green angiography showed decreased choroidal perfusion, and optical coherence tomography revealed full thickness retinal edema. Magnetic resonance angiography and venography were negative for venous sinus thrombosis or intracranial vascular compromise. Conclusions and Importance: Ocular infarction is a rare and devastating disorder that may result in permanent vision loss. Ethanol sclerotherapy has been reported to be effective in treating arteriovenous malformations. To the best of our knowledge, this is the first report in the literature of ocular infarction following percutaneous ethanol sclerotherapy to highlight this disease with multimodal imaging. Keywords: Ocular infarction, Arteriovenous malformation, Ethanol sclerotherapy, Cherry red spot, Ethanol embolization