Osmotic disruption of the blood-ocular barriers.

Supraophthalmic internal carotid artery infusion of BCNU for brain tumor chemotherapy has been promoted as a method to reduce ocular complications [1-4]. The placement of microcatheters into the supraclinoid carotid artery can occasionally result in selection of the ophthalmic artery, middle cerebral artery, or anterior cerebral artery. This report describes an avoidable complication of microcatheter placement related to hyperosmolar contrast material. The authors suggest that low-osmolality contrast agents be used whenever microcatheters are advanced into the supraclinoid carotid .