Central retinal and posterior ciliary artery occlusion after intralesional injection of sclerosant to glabellar subcutaneous hemangioma

Cardiovasc Intervent Radiol. 2009 Mar;32(2):341-6. doi: 10.1007/s00270-008-9382-9. Epub 2008 Jun 20.


The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Ciliary Arteries / pathology*
  • Fluorescein Angiography
  • Hemangioma, Capillary / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Nose Neoplasms / therapy*
  • Ophthalmoscopes
  • Polidocanol
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects*
  • Retinal Artery Occlusion / chemically induced*
  • Retinal Artery Occlusion / diagnosis
  • Sclerosing Solutions / administration & dosage
  • Sclerosing Solutions / adverse effects*
  • Sclerotherapy / adverse effects*
  • Visual Acuity


  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols