title: Retinal Branch Artery Embolization Following Hyaluronic Acid Injection: A Case Report.
abstract: Injection of hyaluronic acid (HA) filler is a common aesthetic procedure. Impairment of vision, although rare, is a devastating complication of this procedure, which may not be reversible. We report on a patient who experienced visual acuity impairment and ischemic oculomotor nerve palsy after injection of HA into the nasal dorsum. In this case, clinical signs improved within 14 days of treatment. We also provide a review of the mechanism, clinical features, risk factors, and prevention and treatment strategies relating to embolization of ocular circulation after injection of HA. Vision loss is a rare but devastating complication of injection of hyaluronic acid (HA) in the face. Visual acuity seldom recovers completely. We report on a 22-year-old Asian woman who experienced obstruction of a branch of the retinal artery after injection of HA to augment her nose. The patient's visual acuity declined shortly after the procedure, and ophthalmoplegia occurred. Combination treatment was administered to restore the perfusion and oxygen supply to the retina and optic nerve. Within 14 days of rigorous treatment, the patient experienced improvement in visual acuity, extraocular movement, and visual field defects. LEVEL OF EVIDENCE 5: Risk.
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wu
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Xing-Ling
authors.initials: XL
authors.lastname: Jian
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Jin-Ying
authors.initials: JY
authors.lastname: Li
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Qin
authors.affiliation: Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D003911:Dextrans / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects*; D008689:Methacrylates / Q000627:therapeutic use; D009296:Nasal Cavity; D009886:Ophthalmoplegia / Q000139:chemically induced / Q000188:drug therapy; D010100:Oxygen / Q000627:therapeutic use; D012161:Retinal Artery / Q000503:physiopathology; D012991:Solanaceous Alkaloids / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014031:Tobramycin / Q000627:therapeutic use; D014786:Vision Disorders / Q000139:chemically induced* / Q000188:drug therapy*; D014805:Vitamin B 12 / Q000031:analogs & derivatives / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003911:Dextrans; D008689:Methacrylates; D012991:Solanaceous Alkaloids; C003922:anisodamine; D003907:Dexamethasone; D013999:Timolol; D006820:Hyaluronic Acid; C019476:mecobalamin; D000527:Alprostadil; C034364:ozagrel; D014805:Vitamin B 12; D010100:Oxygen; D014031:Tobramycin