title: Vision outcomes and major complications after endovascular coil embolization of ophthalmic segment aneurysms.
abstract: OBJECTIVE
  As aneurysms arising from the ophthalmic segment of the internal carotid artery increase in size, they can compress the optic nerve, prompting patients to present with visual disturbances. The purpose of this article is to describe the clinical and angiographic results with an emphasis on visual outcomes following the endovascular treatment of ophthalmic segment ICA aneurysms.
  
  
  METHODS
  The records of 1254 patients who presented for endovascular treatment of a cerebral aneurysm were retrospectively reviewed to identify 65 consecutive patients who underwent coil embolization of an ophthalmic segment ICA aneurysm. The clinical records, treatment reports, and imaging were reviewed with a focus on visual outcomes.
  
  
  RESULTS
  Twenty-two of the 65 patients (34%) who presented for treatment of an ophthalmic aneurysm reported a visual disturbance at presentation. Fifteen of the 22 patients (68%) experienced an improvement in their symptoms after treatment. Overall, patients with visual symptoms were significantly more likely to benefit from treatment than to have a decline in vision (P = .03). The overall morbidity was 4%, and mortality was 0%. The retreatment rate was high at 30%, though this was disproportionately weighted by an 86% retreatment rate in patients with ruptured aneurysms.
  
  
  CONCLUSIONS
  Patients with visual symptoms attributable to ophthalmic segment ICA aneurysms undergoing endovascular coil embolization were statistically more likely to experience an improvement in their vision than to have worsening or unchanged vision. Coiling was associated with a low morbidity rate, though an elevated retreatment rate.
authors.affiliation: From the Departments of Radiology and Medical Imaging (C.R.D., J.G., M.E.J., A.J.E.) cdurst@virginia.edu.
authors.forename: C R
authors.initials: CR
authors.lastname: Durst
authors.affiliation: Neurosurgery (R.M.S.).
authors.forename: R M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: From the Departments of Radiology and Medical Imaging (C.R.D., J.G., M.E.J., A.J.E.).
authors.forename: J
authors.initials: J
authors.lastname: Gaughen
authors.affiliation: Department of Radiology (Q.N.), Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Q
authors.initials: Q
authors.lastname: Nguyen
authors.affiliation: Public Health Services (J.P.), University of Virginia, Charlottesville, Virginia.
authors.forename: J
authors.initials: J
authors.lastname: Patrie
authors.affiliation: From the Departments of Radiology and Medical Imaging (C.R.D., J.G., M.E.J., A.J.E.).
authors.forename: M E
authors.initials: ME
authors.lastname: Jensen
authors.affiliation: From the Departments of Radiology and Medical Imaging (C.R.D., J.G., M.E.J., A.J.E.).
authors.forename: A J
authors.initials: AJ
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging; D001807:Blood Vessel Prosthesis; D002343:Carotid Artery, Internal / Q000601:surgery*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology