Purtscher-Like Retinopathy and Paracentral Acute Middle Maculopathy Caused by Industrial Silicone Embolism

Abstract

This is a case of Purtscher-like retinopathy associated with paracentral acute middle maculopathy caused by industrial silicone embolism after an illicit cosmetic procedure for buttock augmentation. Color fundus photography and optical coherence tomography were able to determine the characteristics features of Purtscher-like retinopathy and paracentral acute middle maculopathy.

Retinal arteriole occlusions associated with microembolization following silicone gluteal injections

“…To the best of our knowledge, there are only three reports of vision loss secondary to cosmetic injection below the face, with each case presenting as Purtscher like retinopathy. 2–4 By contrast, the current patient presented with peripheral nonperfusion from presumed silicone microembolization with associated neovascularization. Given the absence of prior angiograms, the role of systemic lupus erythematosus in the peripheral nonperfusion cannot be ascertained although the presence of intraretinal silicone deposits and systemic complications of silicone embolism syndrome make the etiology of silicone microembolization more likely.…”

“…1 Three cases of vision loss presenting as Purtscher like retinopathy after nonfacial cosmetic injections have previously been described. [2][3][4] We describe a patient with retinal vascular occlusions and neovascularization associated with presumed silicone microembolization 12 years after receiving silicone gluteal injections.…”

Small Paracentral Acute Middle Maculopathy Lesions as Biomarker of Vascular Morbidity: Natural Course

“…Over years of accurate reporting of PAMM cases, the spectrum of potential causative factors has expanded to several dozen systemic disorders, external factors, and drugs. This includes sickle cell disease [20,21]; giant-cell arteritis [22,23]; embolic events, including those after filler injections [24,25]; and different ocular procedures, such as vitrectomy [26]. Other sporadic factors include migraine [27], viral infections [28], and COVID-19 [29].…”