Lee Chang Mok, Hong In Hwan, Park Sung Pyo
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2011 Oct;25(5):358-61. doi: 10.3341/kjo.2011.25.5.358. Epub 2011 Sep 20.
We report a case of ophthalmic artery obstruction combined with brain infarction following periocular autologous fat injection. The patient, a 44-year-old woman, visited our hospital for decreased visual acuity in her left eye and dysarthria one hour after receiving an autologous fat injection in the periocular area. Her best corrected visual acuity for the concerned eye was no light perception. Also, a relative afferent pupillary defect was detected in this eye. The left fundus exhibited widespread retinal whitening with visible emboli in several retinal arterioles. Diffusion-weighted magnetic resonance imaging of the brain showed a hyperintense lesion at the left insular cortex. Therefore, we diagnosed ophthalmic artery obstruction and left middle cerebral artery infarction due to fat emboli. The patient was managed with immediate ocular massage, carbon dioxide, and oxygen therapy. Following treatment, dysarthria improved considerably but there was no improvement in visual acuity.
我们报告一例眼周自体脂肪注射后发生眼动脉阻塞合并脑梗死的病例。患者为一名44岁女性，在眼周区域接受自体脂肪注射1小时后因左眼视力下降和构音障碍前来我院就诊。患眼最佳矫正视力无光感。此外，该眼检测到相对性传入瞳孔障碍。左眼眼底呈现广泛的视网膜变白，在几条视网膜小动脉中可见栓子。脑部弥散加权磁共振成像显示左侧岛叶皮质有高信号病变。因此，我们诊断为脂肪栓塞导致的眼动脉阻塞和左侧大脑中动脉梗死。患者接受了立即眼部按摩、二氧化碳和氧气治疗。治疗后，构音障碍明显改善，但视力没有改善。
