{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:01:18Z","timestamp":1784916078848,"version":"3.55.0"},"reference-count":19,"publisher":"BMJ","funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["MOH-001461"],"award-info":[{"award-number":["MOH-001461"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2026,7,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Orbital infarction syndrome (OrbIS) is a rare but devastating complication following mechanical thrombectomy for ischemic stroke, characterized by a near-global ischemia of intraocular and orbital tissues. It can mimic a more benign secondary orbital inflammation (SOIN), leading to diagnostic uncertainty. We present the largest case series of seven patients who developed acute periorbital swelling following endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion with clinically diagnosed OrbIS or SOIN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of our EVT database was performed and patients who developed these orbital complications were identified. Clinical features, angiographic findings, and outcomes were analyzed, and a literature review was performed to contextualize our findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 1179 patients, four patients were diagnosed with OrbIS and three with SOIN. Patients with OrbIS usually presented within the first 12 hours following EVT and had irreversible vision loss, while those with SOIN had a more delayed onset and good visual recovery. The pathophysiologic spectrum may reflect differing degrees of ischemia, collateral compromise, and secondary inflammatory or reperfusion-related injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Orbital complications following thrombectomy represent a spectrum from complete ischemia with poor outcomes to secondary transient inflammation with good outcomes. Early recognition, prompt ophthalmic consultation, and interdisciplinary management are crucial for optimizing outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2026-025652","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:20:20Z","timestamp":1784913620000},"page":"jnis-2026-025652","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding the spectrum between orbital infarction syndrome and secondary orbital inflammation following endovascular thrombectomy: a case series"],"prefix":"10.1136","author":[{"given":"Maryanne Chew","family":"Romero","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-9945","authenticated-orcid":false,"given":"Mingxue","family":"Jing","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pervinder","family":"Bhogal","sequence":"additional","affiliation":[{"name":"Department of Imaging, The Royal London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hnin Su Wai","family":"Khin","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Neuroscience Institute, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Gopinathan","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenn Haw","family":"Fong","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cunli","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Woodlands Health Campus, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hock-Luen","family":"Teoh","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1805-6665","authenticated-orcid":false,"given":"Yimin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Y Q","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Hui","family":"Sia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Mathews","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus Z H","family":"Yuen","sequence":"additional","affiliation":[{"name":"NUS Yong Loo Lin School of Medicine, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S H","family":"Teo","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihui","family":"Goh","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua Y P","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangadhara","family":"Sundar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard L L","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Neurology. Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"2026072410201705000_jnis-2026-025652v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.125.3.422"},{"key":"2026072410201705000_jnis-2026-025652v1.2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3341\/kjo.2000.14.2.107","article-title":"Two cases of orbital infarction syndrome","volume":"14","author":"Yang","year":"2000","journal-title":"Korean J Ophthalmol"},{"key":"2026072410201705000_jnis-2026-025652v1.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2021.101063","article-title":"Orbital infarction syndrome following hyaluronic acid filler rhinoplasty","volume":"22","author":"Eldweik","year":"2021","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2026072410201705000_jnis-2026-025652v1.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-234158","article-title":"Orbital infarction syndrome after mechanical thrombectomy in acute ischaemic stroke","volume":"13","author":"Valls Carb\u00f3","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2026072410201705000_jnis-2026-025652v1.5","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/acn3.529","article-title":"Inflammatory mediator expression within retrieved clots in acute ischemic stroke","volume":"5","author":"Baek","year":"2018","journal-title":"Ann Clin Transl Neurol"},{"key":"2026072410201705000_jnis-2026-025652v1.6","doi-asserted-by":"crossref","first-page":"90","DOI":"10.15406\/jnsk.2022.12.00507","article-title":"Orbital inflammatory syndrome after mechanical thrombectomy of acute carotid occlusion","volume":"12","author":"Silva","year":"2022","journal-title":"J Neurol Stroke"},{"key":"2026072410201705000_jnis-2026-025652v1.7","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1161\/STROKEAHA.126.055484","article-title":"Incidence and Risk Factors of Retinal Ischemic Complications After Internal Carotid Artery Stenting","volume":"57","author":"Cao","year":"2026","journal-title":"Stroke"},{"key":"2026072410201705000_jnis-2026-025652v1.8","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/1591019920926079","article-title":"Exophthalmos following mechanical thrombectomy for anterior circulation stroke: A retrospective study and review of literature","volume":"26","author":"Volders","year":"2020","journal-title":"Interv Neuroradiol"},{"key":"2026072410201705000_jnis-2026-025652v1.9","doi-asserted-by":"crossref","DOI":"10.1161\/SVIN.123.001400","article-title":"Incidence of Orbital Infarction Syndrome Following Anterior Circulation Endovascular Thrombectomy","volume":"4","author":"MacMillan\u2010Wang","year":"2024","journal-title":"SVIN"},{"key":"2026072410201705000_jnis-2026-025652v1.10","doi-asserted-by":"crossref","first-page":"e111","DOI":"10.1097\/WNO.0000000000001659","article-title":"Orbital Infarction Syndrome as a Rare Complication After Mechanical Thrombectomy in Ischemic Stroke","volume":"44","author":"Rapillo","year":"2024","journal-title":"J Neuroophthalmol"},{"key":"2026072410201705000_jnis-2026-025652v1.11","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.wneu.2018.06.082","article-title":"Orbital Infarction Syndrome Following Mechanical Thrombectomy Secondary to Embolization in New Territory","volume":"117","author":"Brinjikji","year":"2018","journal-title":"World Neurosurg"},{"key":"2026072410201705000_jnis-2026-025652v1.12","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.3341\/jkos.2020.61.9.1104","article-title":"Orbital Infarction Syndrome after Thrombectomy for Internal Carotid Artery Occlusion","volume":"61","author":"Lee","year":"2020","journal-title":"J Korean Ophthalmol Soc"},{"key":"2026072410201705000_jnis-2026-025652v1.13","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1055\/s-0043-1777011","article-title":"An Eye Opener for a Blinding Disease-Orbital Infarction Syndrome","volume":"34","author":"Kaushik","year":"2024","journal-title":"Indian J Radiol Imaging"},{"key":"2026072410201705000_jnis-2026-025652v1.14","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-024-04419-0","article-title":"Orbital infarction syndrome following mechanical thrombectomy in internal carotid artery occlusion: a case report","volume":"18","author":"Tran","year":"2024","journal-title":"J Med Case Rep"},{"key":"2026072410201705000_jnis-2026-025652v1.15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1001\/jamaneurol.2018.2880","article-title":"Global Orbital Infarction Syndrome After a Carotid Artery Dissection","volume":"76","author":"Larrosa Campo","year":"2019","journal-title":"JAMA Neurol"},{"key":"2026072410201705000_jnis-2026-025652v1.16","doi-asserted-by":"crossref","unstructured":"Arazi M , Yaniv G , Ben-Simon G . 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