title: Ocular ischemia with hypotony after injection of hyaluronic acid gel.
abstract: The authors experienced a case with ocular ischemia with hypotony following injection of a dermal filler for augmentation rhinoplasty. Immediately after injection, the patient demonstrated a permanent visual loss with typical fundus features of central retinal artery occlusion. Multiple crusted ulcerative patches around the nose and left periorbit developed, and the left eye became severely inflamed, ophthalmoplegic, and hypotonic. Signs of anterior and posterior segment ischemia were observed including severe cornea edema, iris atrophy, and chorioretinal swelling. The retrograde arterial embolization of hyaluronic acid gel from vascular branches of nasal tip to central retinal artery and long posterior ciliary artery was highly suspicious. After 6 months of follow up, skin lesions and eyeball movement became normalized, but progressive exudative and tractional retinal detachment was causing phthisis bulbi.
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Won Kyung
authors.initials: WK
authors.lastname: Song
authors.forename: Sang Yeul
authors.initials: SY
authors.lastname: Lee
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology; D005123:Eye / Q000098:blood supply*; D005260:Female; D005782:Gels; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects*; D007511:Ischemia / Q000139:chemically induced*; D015814:Ocular Hypotension / Q000139:chemically induced*; D015835:Ocular Motility Disorders / Q000139:chemically induced; D010211:Papilledema / Q000139:chemically induced; D015356:Retinal Artery Occlusion / Q000139:chemically induced; D012225:Rhinoplasty; D015595:Skin Aging / Q000187:drug effects; D012883:Skin Ulcer / Q000139:chemically induced
chemical_list: D005782:Gels; D006820:Hyaluronic Acid; C445361:Restylane