Administration Method and Potential Efficacy of Hyaluronidase for Hyaluronic Acid Filler-Related Vision Loss: A Systematic Review

Xiao, Haodong; Kou, Wei; Yang, Yuan; Dai, Erfu; Zhang, Xuerui; Wen, Yanjun; Peng, Jie; Fei, Ping; Zhao, Peiquan

doi:10.1007/s00266-022-03215-9

Cited by 9 publications

(10 citation statements)

References 62 publications

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“…In most reported cases of visual impairment after HA injection as facial filler, injection was performed in a single location (generally at the nasal root), 5,8 consistent with injection method used in our patient. Other sites of facial filler injection associated with visual impairment include the forehead, glabella, temples, upper eyelid margin, eyebrows, and midface.…”

Section: Discussionsupporting

confidence: 65%

“…1,32 However, the injection method, dose, and efficacy remain uncertain, particularly among patients who do not rapidly seek treatment. 1,5,8,27,32,36 There is controversy concerning the efficacy and safety of thrombolysis treatment for RAO; large-scale, randomized, controlled phase III clinical trials are urgently needed to resolve this debate.…”

Section: Discussionmentioning

confidence: 99%

“…Other sites of facial filler injection associated with visual impairment include the forehead, glabella, temples, upper eyelid margin, eyebrows, and midface. 5,8 These regions receive blood supply either from the arteriolar network connected to the ophthalmic artery or from the facial artery, which is usually linked to branches of the ophthalmic artery. 30 Blood flow to the eye travels from the internal carotid artery-ophthalmic artery to branches that supply intraocular structures (e.g., posterior ciliary and central retinal arteries) and extraocular muscles (e.g., dorsal nasal, supraorbital, and frontal arteries); these branches also supply nearby facial tissues and anastomose with branches of the external carotid artery.…”

Section: Possible Mechanisms Underlying Rao Onsetmentioning

confidence: 99%

“…Although facial filler injection is safer and more easily controlled than conventional surgery, the emergence of this new method has led to increasing reports of serious adverse events, such as arterial obstruction-related vision loss, skin changes, muscle paralysis, and periorbital vascular lesions. 1,[3][4][5][6][7][8][9][10][11] Thus far, no authoritative clinical guidelines have been established.…”

Section: Introductionmentioning

confidence: 99%

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Retinal artery occlusion after facial filler injection in a patient with patent foramen ovale: a case report and literature review

Si,

Wang

2023

J Int Med Res

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We describe a young woman with patent foramen ovale who developed multiple retinal artery occlusion in the right eye after injection of hyaluronic acid into the nasal root. She reported a gradual decline in visual acuity, with visual field defects that had developed in two stages. Multiple retinal artery occlusion was confirmed by slit-lamp examination, dilated fundus examination, optical coherence tomography, visual field examination, and fundus fluorescein angiography. A patent foramen ovale was detected by electrocardiography, transesophageal echocardiography, and transthoracic sonography. The patient was treated with intravenous dexamethasone and cobamamide, as well as extracorporeal counterpulsation therapy; this approach has not been described in previous literature regarding retinal artery occlusion. The patient’s visual acuity improved from counting fingers at 30 cm to 20/133 within 3 days. Our report emphasizes the need for better understanding of vascular anatomy to minimize the risk of complications. Moreover, patients undergoing hyaluronic acid injection should receive information regarding the potential for mild and severe complications; relevant tests should be performed before surgery to exclude vulnerable patients. Finally, a nursing system is needed to facilitate the emergency recognition, triage, and management of retinal artery occlusion.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Possible Mechanisms Underlying Rao Onsetmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retinal artery occlusion after facial filler injection in a patient with patent foramen ovale: a case report and literature review

Si,

Wang

2023

J Int Med Res

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“…Facial filler injections into the vasculature can induce serious complications. [8][9][10] The main reasons why facial fillers cause vascular embolism or ischemia after facial filling are partial or complete occlusion caused by the injection of the filler into the blood vessel in the direction of the blood flow or against the blood flow, or the accumulation of the filler on the outer side of the blood vessel, which compresses the blood vessel. Vision loss was the most common adverse reaction in all the vascular occlusion cases reported, mainly caused by OAO, BRAO, PCAO, and CRAO.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Zhuang,

Zheng,

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Embolism is a serious complication after facial filling, with a usually poor prognosis of the symptoms after embolism. The authors systematically reviewed reported cases of facial vascular embolism, explored the relationship between the location and material used for facial filling and occurrence of vascular embolism, and assessed the prognosis of complications after vascular embolism. Methods: This study provides a systematic review of published cases of vascular embolism after facial filling. A summary of the filling materials and filling sites for each case, the adverse reactions and embolized blood vessels, a recording of the time when each patient experienced adverse reactions and started treatment, and a presentation of their prognosis are provided. Results: The frontal, eyebrow, and nose are common filling sites causing facial embolism. The main clinical manifestations after embolism were visual impairment, skin necrosis, and ptosis. The prognosis of visual impairment after embolization was poor, whereas skin necrosis and ptosis generally improved after treatment. Conclusions: This article aimed to review the clinical manifestations, therapies, and prognosis of embolism after facial filling. A better understanding of these complications can help clinicians to detect the occurrence of complications as early as possible and give patients timely treatment.

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Oclusión de la arteria central de la retina tras inyección facial de ácido hialurónico

Asensio-Sánchez

2023

Archivos de la Sociedad Española de Oftalmología

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Administration Method and Potential Efficacy of Hyaluronidase for Hyaluronic Acid Filler-Related Vision Loss: A Systematic Review

Cited by 9 publications

References 62 publications

Retinal artery occlusion after facial filler injection in a patient with patent foramen ovale: a case report and literature review

Retinal artery occlusion after facial filler injection in a patient with patent foramen ovale: a case report and literature review

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Oclusión de la arteria central de la retina tras inyección facial de ácido hialurónico

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