BMC Surgery | |
Choroid vascular occlusion and ischemic optic neuropathy after facial calcium hydroxyapatite injection- a case report | |
Hui-Ju Lin3  You-Ling Li2  Yi-Yu Tsai2  Hsin-Han Chen1  Chien-Chih Chou2  | |
[1] Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan;Department of Ophthalmology, China Medical University Hospital, No. 2 Yuh Der Road, Taichung 404, Taiwan;School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan | |
关键词: Filler; Vision loss; Ischemic optic neuropathy; Choroid vascular occlusion; Nose augmentation; Calcium hydroxyapatite; | |
Others : 1138384 DOI : 10.1186/s12893-015-0007-3 |
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received in 2014-11-26, accepted in 2015-02-10, 发布年份 2015 | |
【 摘 要 】
Background
We reported a case of sudden monocular vision loss after calcium hydroxyapatite (CaHA) injection into the nasal tip and dorsum with detailed retina images.
Case presentation
A healthy, 35-year-old woman received CaHA filler injection for nose augmentation. Ten minutes after the procedure, she developed nausea, vomiting, headache, ptosis, and left periorbital pain. After 30 minutes, she complained of progressively blurring vision in the left eye. The best-corrected visual acuity (BCVA) in her left eye was 30 cm ahead of hand motion. Left exotropia was noted in primary gaze. Limitations in adduction, supraduction, and infraduction of the left eye were also observed. Slit lamp examination of the left eye revealed a pink conjunctiva, a clear cornea, a mild anterior chamber reaction, a sluggish papillary light reflex, and a semi-dilated pupil. A positive relative afferent pupillary defect was observed in the left eye. Fundus examination revealed optic disc edema and some linear whitish opacity over the superior and temporal sites in the left eye, suggesting multiple CaHA emboli in the choroid vessels.
Conclusions
Although the majority of adverse reactions are mild and transient, surgeons should be alert about extremely rare serious adverse events such as visual loss.
【 授权许可】
2015 Chou et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
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20150320020729576.pdf | 800KB | download | |
Figure 3. | 17KB | Image | download |
Figure 2. | 28KB | Image | download |
Figure 1. | 40KB | Image | download |
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【 参考文献 】
- [1]Jacovella PF: Use of calcium hydroxylapatite (Radiesse®) for facial augmentation. Clin Interv Aging 2008, 3(1):161-74.
- [2]Jurado JR, Lima LF, Olivetti IP, Arroyo HH, de Oliveira IH: Innovations in minimally invasive facial treatments. Facial Plast Surg 2013, 29(3):154-60.
- [3]Funt D, Pavicic T: Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 2013, 6:295-316.
- [4]Dreizen NG, Framm L: Sudden visual loss after autulogous fat injection into the glabellar area. Am J Ophthalmol 1989, 107:85-7.
- [5]Danesh-Meyer HV, Savino PJ, Sergott RC: Case reports and small case series: ocular and cerebral ischemia following facial injection of autologous fat. Arch Ophthalmol 2011, 119:777-8.
- [6]Peter S, Mennel S: Retinal branch artery occlusion following injection of hyaluronic acid (Restylane). Clin Experiment Ophthalmol 2006, 34:363-4.
- [7]Lazzeri D, Agostini T, Figus M, Nardi M, Pantaloni M, Lazzeri S: Blindness following cosmetic injections of the face. Plast Reconstr Surg 2012, 129(4):995-1012.
- [8]Park SW, Woo SJ, Park KH, Huh JW, Jung C, Kwon OK: Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. Am Ophthalmol 2012, 154(4):653-66.
- [9]Park KH, Kim YK, Woo SJ, Kang SW, Lee WK, Choi KS, et al.: Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections: a national survey by the Korean Retina Society. JAMA Ophthalmol 2014, 132(6):714-23.
- [10]Sung MS, Kim HG, Woo KI, Kim YD: Ocular ischemia and ischemic oculomotor nerve palsy after vascular embolization of injectable calcium hydroxylapatite filler. Ophthal Plast Reconstr Surg 2010, 26:289-91.