Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Am J Ophthalmol. 2012 Oct;154(4):653-662.e1. doi: 10.1016/j.ajo.2012.04.019. Epub 2012 Jul 25.
To investigate the clinical manifestations and visual prognosis of retinal artery occlusion resulting from cosmetic facial filler injections.
Retrospective, noncomparative case series.
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.
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.
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.
探讨美容面部填充物注射导致视网膜动脉阻塞的临床表现和视力预后。
回顾性、非对照病例系列。
机构设置。研究人群：12 例因美容面部填充物注射导致视网膜动脉阻塞的连续患者。主要观察指标：填充物材料、注射部位、最佳矫正视力、眼底荧光素血管造影和光学相干断层扫描结果以及相关的眼部和全身表现。
7 例、2 例和 3 例患者分别发生眼动脉、中央视网膜动脉和分支视网膜动脉阻塞。注射材料包括自体脂肪（7 例）、透明质酸（4 例）和胶原蛋白（1 例），注射部位为额部（7 例）、鼻唇沟（4 例）或两者（1 例）。注射的自体脂肪与其他材料相比，最终最佳矫正视力更差。所有眼动脉阻塞患者均有眼部疼痛，且最佳矫正视力无改善。光学相干断层扫描显示眼动脉阻塞眼的脉络膜较薄，血管较少，而相邻正常眼则较厚，血管较多。中央视网膜动脉阻塞和眼动脉阻塞各有 2 例患者并发脑梗死。眼动脉阻塞导致 1 例眼球萎缩。
在额部或鼻唇沟注射美容填充物可导致视网膜动脉阻塞。医源性眼动脉阻塞与疼痛性失明、脉络膜变薄、脑梗死和视力预后不良相关，尤其是使用自体脂肪时。对于此类注射后出现眼部疼痛的患者，应进行眼科检查和系统脑部磁共振成像检查。
