title: PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH RETINAL ARTERY OCCLUSION AFTER COSMETIC FILLER INJECTION.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A 35-year-old woman presenting with sudden vision loss to finger count vision immediately after left nasal fat pad cosmetic filler injection.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Jayanth
authors.initials: J
authors.lastname: Sridhar
authors.forename: Abtin
authors.initials: A
authors.lastname: Shahlaee
authors.forename: Wen-Shi
authors.initials: WS
authors.lastname: Shieh
authors.forename: Ehsan
authors.initials: E
authors.lastname: Rahimy
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005123:Eye / Q000098:blood supply; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D015356:Retinal Artery Occlusion / Q000150:complications / Q000209:etiology; D012164:Retinal Diseases / Q000175:diagnosis*