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A healthy 25-year-old man who received a calcium hydroxylapatite filler injection for nose augmentation by a dermatologist suddenly developed blepharoptosis and orbital pain on the right side, associated with progressive visual disturbance of the right eye. Patchy necrosis at the nose and glabella, limitations of extraocular movements, and anterior segment ischemia, as evidenced by conjunctival injection, chemosis, corneal edema, dilated pupil, hyphema, and hypopyon, were noted. Orbital CT demonstrated linear deposits of a similar density to bone in the right medial orbit and eyelid, suggestive of multiple emboli along the conjunctival vessels. A provisional diagnosis of ocular ischemia and ischemic oculomotor nerve palsy secondary to vascular embolization was made. After 3 months, visual acuity, all intraocular inflammation, oculomotor nerve palsy, and skin necrosis resolved completely except for a dilated pupil.

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We investigated the association between retinal changes measured using optical coherence tomography (OCT) and diverse clinical grading scales in patients with Parkinson’s disease (PD). Seventy-four eyes of 74 patients with de novo PD and 53 eyes of age-matched control subjects were included. The thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) were measured. We analyzed the correlations between the clinical PD grading scales and OCT parameters, and between the OCT parameters and volumetric data in the cerebral cortical and subcortical structures. The area under the receiver operating characteristic curve (AUC) was calculated for diagnosing cognitive impairment in patients with PD. Statistically significant reductions in the thickness of average, temporal, and inferior pRNFL and overall mGCIPL were observed in patients with PD. The Montreal Cognitive Assessment score was significantly associated with mGCIPL thinning. The AUC of the mGCIPL parameters for diagnosing cognitive impairment in patients with PD ranged from 0.651 to 0.760. Moreover, thinning of the mGCIPL was significantly associated with the volumetric parameters of associated brain structures. Our findings highlight the clinical implications of OCT measurements as a potential biomarker for early detection of cognitive impairment in patients with PD.