Sridhar Jayanth, Shahlaee Abtin, Shieh Wen-Shi, Rahimy Ehsan
Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Retin Cases Brief Rep. 2017;11 Suppl 1:S216-S218. doi: 10.1097/ICB.0000000000000466.
To report a single case of paracentral acute middle maculopathy in association with retinal artery occlusion in the setting of ipsilateral facial cosmetic filler injection.
Case report.
A 35-year-old woman presenting with sudden vision loss to finger count vision immediately after left nasal fat pad cosmetic filler injection.
Dilated funduscopic examination revealed a swollen optic disc with multiple branch arterial occlusions with visible embolic material. Fluorescein angiography confirmed multiple branch arterial occlusions in addition to a focal choroidal infarction in the macula. Spectral-domain optical coherence tomography revealed middle retinal hyperreflectivity in the superotemporal macula consistent with paracentral acute middle maculopathy. En face optical coherence tomography demonstrated a superotemporal area of whitening at the level of the deep capillary plexus corresponding to the paracentral acute middle maculopathy lesion seen on spectral-domain optical coherence tomography. On twelve-month follow-up, final visual acuity was 20/100 due to optic neuropathy.
Emboli from cosmetic facial filler injections may rarely result in ipsilateral arterial occlusions and now have a novel association with paracentral acute middle maculopathy likely due to deep capillary plexus feeder vessel occlusion.
报告一例在同侧面部注射美容填充剂后出现的与视网膜动脉阻塞相关的中心旁急性黄斑病变的病例。
病例报告。
一名35岁女性，在左侧鼻脂肪垫注射美容填充剂后立即出现突然视力丧失至仅能数指。
散瞳眼底检查发现视盘肿胀，有多处分支动脉阻塞，可见栓子。荧光素血管造影证实除黄斑区局灶性脉络膜梗死外，还有多处分支动脉阻塞。频域光学相干断层扫描显示颞上黄斑区视网膜中层高反射，符合中心旁急性黄斑病变。正面光学相干断层扫描显示在深层毛细血管丛水平有一个颞上区域变白，对应于频域光学相干断层扫描上所见的中心旁急性黄斑病变。在12个月的随访中，由于视神经病变，最终视力为20/100。
面部美容填充剂注射的栓子可能很少导致同侧动脉阻塞，现在发现与中心旁急性黄斑病变有新的关联，可能是由于深层毛细血管丛供血血管阻塞所致。
