Fundus artery occlusion caused by cosmetic facial injections.
BACKGROUND
With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections.


METHODS
Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity (BCVA), fundus fluorescein angiography, and associated ocular and systemic manifestations.


RESULTS
Eleven patients had ophthalmic artery occlusion (OAO) and one patient each had central retinal artery occlusion (CRAO) and anterior ischemic optic neuropathy (AION). Injected materials included autologous fat (seven cases), hyaluronic acid (five cases), and bone collagen (one case). Injection sites were the frontal area (five cases), periocular area (two cases), temple area (two cases), and nose area and nasal area (4 cases). Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA.


CONCLUSIONS
Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid injection.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Yanyun
Y
Chen
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Wenying
W
Wang
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Jipeng
J
Li
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Yajie
Y
Yu
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Lin
L
Li
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China.
Ning
N
Lu
D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007271:Injections, Intradermal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000175:diagnosis* / Q000209:etiology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult