title: Iatrogenic occlusion of the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Retina Society.
abstract: OBJECTIVE
  Iatrogenic occlusion of the ophthalmic artery and its branches is a rare but devastating complication of cosmetic facial filler injections.
  
  
  OBJECTIVE
  To investigate clinical and angiographic features of iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections.
  
  
  METHODS
  Data from 44 patients with occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections were obtained retrospectively from a national survey completed by members of the Korean Retina Society from 27 retinal centers. Clinical features were compared between patients grouped by angiographic findings and injected filler material.
  
  
  METHODS
  Visual prognosis and its relationship to angiographic findings and injected filler material.
  
  
  RESULTS
  Ophthalmic artery occlusion was classified into 6 types according to angiographic findings. Twenty-eight patients had diffuse retinal and choroidal artery occlusions (ophthalmic artery occlusion, generalized posterior ciliary artery occlusion, and central retinal artery occlusion). Sixteen patients had localized occlusions (localized posterior ciliary artery occlusion, branch retinal artery occlusion, and posterior ischemic optic neuropathy). Patients with diffuse occlusions showed worse initial and final visual acuity and less visual gain compared with those having localized occlusions. Patients receiving autologous fat injections (n = 22) had diffuse ophthalmic artery occlusions, worse visual prognosis, and a higher incidence of combined brain infarction compared with patients having hyaluronic acid injections (n = 13).
  
  
  CONCLUSIONS
  Clinical features of iatrogenic occlusion of the ophthalmic artery and its branches following cosmetic facial filler injections were diverse according to the location and extent of obstruction and the injected filler material. Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction. Extreme caution and care should be taken during these injections, and physicians should be aware of a diverse spectrum of complications following cosmetic facial filler injections.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi, Korea.
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi, Korea.
authors.forename: Yong-Kyu
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi, Korea.
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Se Woong
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Ophthalmology, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Kyung Seek
authors.initials: KS
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Hyung Woo
authors.initials: HW
authors.lastname: Kwak
authors.affiliation: Department of Ophthalmology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.
authors.forename: Ill Han
authors.initials: IH
authors.lastname: Yoon
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kuhl
authors.initials: K
authors.lastname: Huh
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005145:Face; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects; D007049:Iatrogenic Disease; D015994:Incidence; D007271:Injections, Intradermal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000503:physiopathology*; D011379:Prognosis; D011859:Radiography; D056910:Republic of Korea; D015356:Retinal Artery Occlusion / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012955:Societies, Medical; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D006820:Hyaluronic Acid