Retinal vascular occlusion as the first sign of perineural infiltration from squamous cell carcinoma




Ainsa Ibáñez-García, Department of Strabismus and Pediatric Ophthalmology, Hospital Costa del Sol, Marbella, Malaga, Spain Ana B. González-Escobar, Department of Medical and Surgical Retina, Hospital Costa del Sol, Marbella, Malaga, Spain Jose M. Galván-Cano, Department of Medical and Surgical Retina, Hospital Costa del Sol, Marbella, Malaga, Spain Carmen Lozano-Calero, Department of Radiology. Hospital Costa del Sol, Marbella, Malaga, Spain Ana Chinchurreta-Capote, Department of Medical and Surgical Retina, Hospital Costa del Sol, Marbella, Malaga, Spain


Objective: We present the case of a gentleman with a personal history of squamous cell carcinoma (SCC) treated by surgery and radiotherapy, who had a loss of vision in his right eye due to a vascular occlusion. Two weeks later he suffered a complete right ptosis and ophthalmoplegia. The suspected diagnosis, an orbital apex syndrome (OAS), was first discarded by imaging techniques, but was 1 month later confirmed by clinical evolution and a second magnetic resonance imaging. Results: The SCC has the capacity of local infiltration and distance dissemination. The OAS is characterized by the damage of the structures that pass through the upper orbital fissure and optical channel. Conclusions: OAS diagnosis is based on clinical suspicion and image techniques confirmation; but in cases with clear clinical signs and initial normal analytics and image findings, an early treatment may improve patient’s prognosis and quality of life.



Keywords: Retinal occlusion. Squamous cell carcinoma. Orbital apex syndrome. Perineural infiltration. Frontal nerve.