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Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections.
Am J Ophthalmol 2012; 154(4):653-662.e1AJ

Abstract

PURPOSE

To investigate the clinical manifestations and visual prognosis of retinal artery occlusion resulting from cosmetic facial filler injections.

DESIGN

Retrospective, noncomparative case series.

METHODS

Setting. Institutional. Study Population. Twelve consecutive patients with retinal artery occlusion caused by cosmetic facial filler injections. Main Outcome Measures. Filler materials, injection sites, best-corrected visual acuities, fundus fluorescein angiography and optical coherence tomography findings, and associated ocular and systemic manifestations.

RESULTS

Seven, 2, and 3 patients had ophthalmic, central retinal, and branch retinal artery occlusions, respectively. Injected materials included autologous fat (7 cases), hyaluronic acid (4 cases), and collagen (1 case), and injection sites were the glabellar region (7 cases), nasolabial fold (4 cases), or both (1 case). Injected autologous fat was associated with worse final best-corrected visual acuity than the other materials. All patients with ophthalmic artery occlusion had ocular pain and no improvement in best-corrected visual acuity. Optical coherence tomography revealed thinner and less vascular choroids in eyes with ophthalmic artery occlusion than in adjacent normal eyes. Concomitant brain infarction developed in 2 cases each of central retinal artery occlusion and ophthalmic artery occlusion. Phthisis developed in 1 case of ophthalmic artery occlusion.

CONCLUSIONS

Cosmetic filler injections into the glabellar region or nasolabial fold can cause retinal artery occlusion. Iatrogenic ophthalmic artery occlusion is associated with painful blindness, a thin choroid, brain infarction, and poor visual outcomes, particularly when autologous fat is used. Ophthalmic examination and systematic brain magnetic resonance imaging should be performed in patients with ocular pain after such injections.

Authors+Show Affiliations

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22835509

Citation

Park, Sung Wook, et al. "Iatrogenic Retinal Artery Occlusion Caused By Cosmetic Facial Filler Injections." American Journal of Ophthalmology, vol. 154, no. 4, 2012, pp. 653-662.e1.
Park SW, Woo SJ, Park KH, et al. Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. Am J Ophthalmol. 2012;154(4):653-662.e1.
Park, S. W., Woo, S. J., Park, K. H., Huh, J. W., Jung, C., & Kwon, O. K. (2012). Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. American Journal of Ophthalmology, 154(4), pp. 653-662.e1. doi:10.1016/j.ajo.2012.04.019.
Park SW, et al. Iatrogenic Retinal Artery Occlusion Caused By Cosmetic Facial Filler Injections. Am J Ophthalmol. 2012;154(4):653-662.e1. PubMed PMID: 22835509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. AU - Park,Sung Wook, AU - Woo,Se Joon, AU - Park,Kyu Hyung, AU - Huh,Jang Won, AU - Jung,Cheolkyu, AU - Kwon,O-Ki, Y1 - 2012/07/25/ PY - 2012/02/24/received PY - 2012/04/23/revised PY - 2012/04/24/accepted PY - 2012/7/28/entrez PY - 2012/7/28/pubmed PY - 2012/12/14/medline SP - 653 EP - 662.e1 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 154 IS - 4 N2 - PURPOSE: To investigate the clinical manifestations and visual prognosis of retinal artery occlusion resulting from cosmetic facial filler injections. DESIGN: Retrospective, noncomparative case series. METHODS: Setting. Institutional. Study Population. Twelve consecutive patients with retinal artery occlusion caused by cosmetic facial filler injections. Main Outcome Measures. Filler materials, injection sites, best-corrected visual acuities, fundus fluorescein angiography and optical coherence tomography findings, and associated ocular and systemic manifestations. RESULTS: Seven, 2, and 3 patients had ophthalmic, central retinal, and branch retinal artery occlusions, respectively. Injected materials included autologous fat (7 cases), hyaluronic acid (4 cases), and collagen (1 case), and injection sites were the glabellar region (7 cases), nasolabial fold (4 cases), or both (1 case). Injected autologous fat was associated with worse final best-corrected visual acuity than the other materials. All patients with ophthalmic artery occlusion had ocular pain and no improvement in best-corrected visual acuity. Optical coherence tomography revealed thinner and less vascular choroids in eyes with ophthalmic artery occlusion than in adjacent normal eyes. Concomitant brain infarction developed in 2 cases each of central retinal artery occlusion and ophthalmic artery occlusion. Phthisis developed in 1 case of ophthalmic artery occlusion. CONCLUSIONS: Cosmetic filler injections into the glabellar region or nasolabial fold can cause retinal artery occlusion. Iatrogenic ophthalmic artery occlusion is associated with painful blindness, a thin choroid, brain infarction, and poor visual outcomes, particularly when autologous fat is used. Ophthalmic examination and systematic brain magnetic resonance imaging should be performed in patients with ocular pain after such injections. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/22835509/Iatrogenic_retinal_artery_occlusion_caused_by_cosmetic_facial_filler_injections_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(12)00329-7 DB - PRIME DP - Unbound Medicine ER -