Unilateral Vision Loss After Hyaluronic Acid Injection

Hung, Jia‐Horung; Wang, Chung Ting; Lee, Chaw Ning; Shieh, Shyh Jou

doi:10.1097/sap.0000000000002624

Cited by 12 publications

(3 citation statements)

References 20 publications

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“…( See table, Supplemental Digital Content 1, which displays information on 165 patients. 44–98 http://links.lww.com/PRSGO/C749).…”

Section: Resultsmentioning

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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“…( See table, Supplemental Digital Content 1, which displays information on 165 patients. 44–98 http://links.lww.com/PRSGO/C749).…”

Section: Resultsmentioning

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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“… 9 One case report of vision loss after forehead injection of HA resulted in permanent loss after 5 months; the authors indicated that HBOT had not been started within 24 h of injury which likely hindered its ability to alter the patient's prognosis. 10 Four additional case reports of visual changes after HA injection treated with HBOT also showed no improvement; however, the exact protocol and timing of HBOT are not given. 11-14 Notably, the immediate injection of hyaluronidase in a few of these cases did not improve visual symptoms.…”

Section: Discussionmentioning

confidence: 99%

Complete Vision Recovery After Filler-Induced Blindness Using Hyperbaric Oxygen Therapy: Case Report and Literature Review

Friedman,

Coombs,

Stevens

et al. 2024

Aesthetic Surgery Journal Open Forum

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Injecting soft tissue fillers like hyaluronic acid has become an extremely popular method of facial augmentation. Although rare, adverse effects, ranging from cosmetically dissatisfactory to dangerous may occur. The most severe adverse effect of these is vascular occlusion of the central retinal artery, resulting in vision loss. Protocols for the treatment of filler-induced blindness have not been well established, but there is evidence to suggest that hyperbaric oxygen therapy (HBOT) may aid in the therapeutic algorithm of filler-induced blindness. We present a clinical case of filler-induced blindness successfully treated with prompt administration of HBOT. A 38-year-old healthy woman presented to the emergency room after immediate pain and complete vision loss following at-home injection of mail-order filler into the left glabella and medial eyebrow. After treatment with hyaluronidase and ocular massage, neither of which relieved her symptoms, she received HBOT within 10 hours of injury, after which her vision improved significantly. After two additional sessions the patient had complete vision recovery. This case report contributes to very sparse literature documenting successful treatment of filler-induced blindness using HBOT, advocating for further study and possible incorporation into the treatment algorithm for filler-induced blindness. Improper soft tissue filler administration possesses a potential risk for severe adverse effects. It is crucial that the medical community are aware of treatments that offer the highest chance of visual recovery and sustained benefit for patients.

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“…The main goal is to increase the amount of oxygen dissolved in the plasma. Increased dissolved oxygen works to improve the diffusion distance, supporting oxygen-dependent processes that do not get enough arterial blood supply [53] . One report discussed the case of a 31-year-old woman who received HA filler at the nasal dorsum and developed immediate vision loss in the right eye [54] .…”

Section: Complications Vision Lossmentioning

confidence: 99%

Ischemic complications of dermal fillers

Mehta¹,

Kaplan²,

Zhang-Nunes³

2022

Plast Aesthet Res

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Dermal fillers have become increasingly popular as a cosmetic treatment for facial rejuvenation. Although these injections are generally considered to be safe, as the number of injections has increased, so has the rate of complications. Ischemic complications of fillers is critical and include vision loss, ophthalmoplegia, skin necrosis, and cerebral infarction. Knowing the anatomy well to optimally prevent and manage these serious complications. Prevention includes knowledge of the vascular anatomy of the facial area, as well as certain injection techniques such as aspiration, use of a smaller needle, and adoption of a larger cannula. The use of ultrasound has been a recent innovation in preventing and treating filler complications as well. The reversibility of fillers should also be considered when choosing a filler. Some hyaluronic acid (HA) fillers, including the newer ones on the market, are difficult to reverse and non-HA fillers and fat are irreversible. This review aims to discuss facial anatomy, the various ischemic filler complications, the prevention and management of these complications, and the relatively recent use of imaging as an adjunct.

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Unilateral Vision Loss After Hyaluronic Acid Injection

Cited by 12 publications

References 20 publications

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

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

Complete Vision Recovery After Filler-Induced Blindness Using Hyperbaric Oxygen Therapy: Case Report and Literature Review

Ischemic complications of dermal fillers

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