Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (1): 66-71.doi: 10.6040/j.issn.1673-3770.0.2023.021

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Central retinal artery occlusion caused by facial filling with hyaluronic acid: a case report and literature review

LI Shuting1, ZHAO Hui1, SI Mingwei1, CUI Wenxuan1, YANG Mengyao1, WANG Hong2   

  1. 1. First Clinical College of Shandong University, Jinan 250012, Shandong, China2. Department of Ophthalmology Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2024-01-12

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Abstract: Objective Through the case data of a patient with central retinal artery occlusion(CRAO)caused by hyaluronic acid filling in the nose, the study discusses the pathogenesis and treatment methods. Methods A female patient experienced a sudden loss of visual acuity with superior temporal visual obscuration in the right eye after receiving a nasal hyaluronic acid injection. After treatment at a local hospital, the patient came to our hospital for initial examination, and was treated with medication and external counterpulsation therapy. Results After 3 days of treatment, corrected visual acuity was 0.15 in the right eye; fundus examination showed enhanced optic disc edema and a decrease in the area of peripapillary white spots. Conclusion CRAO is a disease caused by central retinal artery occlusion and corresponding retinal nutrient supply deficiency. External counterpulsation has the distinction of being a non-invasive treatment(therefore avoiding the side effects of invasive treatment)and it is easy to administer and promote, and is an effective adjunctive treatment for CRAO.

Key words: Central retinal artery occlusion, Hyaluronic acid, Extracorporeal counterpulsation, Acute ischemic stroke

CLC Number: 

  • R765.21
[1] Callizo J, Feltgen N, Pantenburg S, et al. Cardiovascular risk factors in central retinal artery occlusion: results of a prospective and standardized medical examination[J]. Ophthalmology, 2015, 122(9): 1881-1888. doi:10.1016/j.ophtha.2015.05.044
[2] 杨培增,范先群.眼科学[M].9版.北京:人民卫生出版社, 2019: 188-191
[3] Hayreh SS, Podhajsky PA, Zimmerman MB. Retinal artery OcclusionAssociated systemic and ophthalmic abnormalities[J]. Ophthalmology, 2009, 116(10): 1928-1936. doi:10.1016/j.ophtha.2009.03.006
[4] Ammous I, Zhioua Braham I, EL Amri Mezghanni K, et al. Occlusion de l'artère centrale de la rétine révélant une endocardite infectieuse[J]. J Français D'ophtalmologie, 2018, 41(4): e167-e168. doi:10.1016/j.jfo.2018.01.001
[5] Kohara K, Ishikawa T, Kobayashi T, et al. Retinal artery occlusion during carotid artery stenting with distal embolic protection device[J]. Neuroradiol J, 2018, 31(5): 504-508. doi:10.1177/1971400918781990
[6] Taylor GI, Shoukath S, Gascoigne A, et al. The functional anatomy of the ophthalmic angiosome and its implications in blindness as a complication of cosmetic facial filler procedures[J]. Plast Reconstr Surg, 2020, 146(4): 745. doi:10.1097/prs.0000000000007155
[7] Tansatit T, Moon HJ, Apinuntrum P, et al. Verification of embolic channel causing blindness following filler injection[J]. Aesth Plast Surg, 2015, 39(1): 154-161. doi:10.1007/s00266-014-0426-z
[8] Beleznay K, Carruthers JDA, Humphrey S, et al. Avoiding and treating blindness from fillers[J]. Dermatol Surg, 2015, 41(10): 1097-1117. doi:10.1097/dss.0000000000000486
[9] Cohen JL, Biesman BS, Dayan SH, et al. Treatment of hyaluronic acid filler-induced impending necrosis with hyaluronidase: consensus recommendations[J]. Aesthet Surg J, 2015, 35(7): 844-849. doi:10.1093/asj/sjv018
[10] 王润生, 雷涛, 王毅, 等. 面部美容注射后眼动脉及脑动脉阻塞的临床特征分析[J]. 中华眼底病杂志, 2019, 35(5): 470-474. doi: 10.3760/cma.j.issn.1005-1015.2019.05.009 WANG Runsheng, LEI Tao, WANG Yi, et al. Analysis of clinical features of ophthalmic and cerebral artery occlusion after facial cosmetic injection[J]. Chinese Journal of Ocular Fundus Diseases, 2019, 35(5): 470-474. doi: 10.3760/cma.j.issn.1005-1015.2019.05.009
[11] 刘江, 文杭, 项敏泓. 玻尿酸注射致视网膜动脉阻塞1例[J]. 中国眼耳鼻喉科杂志,2020,20(6):491-492. doi:10.14166/j.issn.1671-2420.2020.06.020 LIU Jiang, WEN Hang, XIANG Minhong. A case of retinal artery obstruction caused by hyaluronic acid injection[J]. Chinese Journal of Otolaryngology, 2020, 20(6): 491-492. doi:10.14166/j.issn.1671-2420.2020.06.020
[12] 郝美玲,孙艳红,韦企平.头面部皮下注射药物致盲概述[J].中国中医眼科杂志, 2016, 26(6): 413-416. doi:10.13444/j.cnki.zgzyykzz.2016.06.018 HAO Meiling, SUN Yanhong, WEI Qiping. Overview of blinding by subcutaneous drug injection on the head and face[J]. Chinese Journal of Traditional Chinese Medicine and Ophthalmology, 2016, 26(6): 413-416. doi:10.13444/j.cnki.zgzyykzz.2016.06.018
[13] Lazzeri D, Agostini T, Figus M, et al. Blindness following cosmetic injections of the face[J]. Plast Reconstr Surg, 2012, 129(4): 995-1012. doi:10.1097/prs.0b013e3182442363
[14] Zheng H, Qiu L, Liu Z, et al. Exploring the possibility of a retrograde embolism pathway from the facial artery to the ophthalmic artery system in vivo[J]. Aesthetic Plast Surg, 2017, 41(5): 1222-1227. doi:10.1007/s00266-017-0877-0
[15] Ramesh S, Le AL, Katsev B, et al. The force required to inject a column of filler through facial arteries[J]. Dermatol Surg, 2020, 46(9): e32-e37. doi:10.1097/DSS.0000000000002248
[16] Bravo BS, Rocha CR, Bastos JT, et al. Comprehensive treatment of periorbital region with hyaluronic acid[J]. J Clin Aesthet Dermatol, 2015, 8(6): 30-35
[17] 黄明海,郭海科.视网膜中央动脉阻塞的临床治疗研究进展[J].国外医学(眼科学分册), 2004(4): 261-264
[18] 缪娜, 范玮. 视网膜中央动脉阻塞的治疗研究现状及进展[J]. 中华眼底病杂志, 2018, 34(3): 296-299. doi: 10.3760/cma.j.issn.1005-1015.2018.03.023 MIAO Na, FAN Wei. Clinical research status and progress of central retinal artery occlusion[J]. Chinese Journal of Ocular Fundus Diseases, 2018, 34(3): 296-299. doi: 10.3760/cma.j.issn.1005-1015.2018.03.023
[19] 谢礼丹, 张洪, 叶小琴. 基于卒中绿色通道静脉溶栓治疗视网膜分支动脉阻塞1例[J]. 中国中医眼科杂志, 2018, 28(5): 343-345. doi: 10.13444/j.cnki.zgzyykzz.2018.05.017 XIE Lidan, ZHANG Hong, YE Xiaoqin. A case of branch retinal artery occlusion treated by intravenous thrombolysis based on stroke green channel[J]. Chinese Journal of Chinese Ophthalmology, 2018, 28(5): 343-345. doi: 10.13444/j.cnki.zgzyykzz.2018.05.017
[20] 罗茂梅, 蔡善君. 血栓溶解法治疗视网膜中央动脉阻塞[J]. 国际眼科纵览, 2018, 42(6): 406-409. doi: 10.3760/cma.j.issn.1673-5803.2018.06.010 LUO Maomei, CAI Shanjun. Thrombolysis for central retinal artery occlusion[J]. International Review of Ophthalmology, 2018, 42(6): 406-409. doi: 10.3760/cma.j.issn.1673-5803.2018.06.010
[21] 朱爱玲. 视网膜动脉阻塞的治疗新进展[J]. 国外医学(眼科学分册), 1997(2): 90-93
[22] 陈嘉宝, 李金瑛. 视网膜动脉阻塞治疗现状[J]. 国际眼科纵览, 2019, 43(1): 68-72.doi: 10.3760/cma.j.issn.1673-5803.2019.01.014 CHEN Jiabao, LI Jinying. Treatment of retinal artery occlusion[J]. International Review of Ophthalmology, 2019, 43(1): 68-72.doi: 10.3760/cma.j.issn.1673-5803.2019.01.014
[23] Zhang L, Feng X, Shi HY, et al. Blindness after facial filler injections: the role of extravascular hyaluronidase on intravascular hyaluronic acid embolism in the rabbit experimental model[J]. Aesthet Surg J, 2020, 40(3): 319-326. doi:10.1093/asj/sjz280
[24] Carruthers J, Fagien S, Dolman P. Retro or PeriBulbar injection techniques to reverse visual loss after filler injections[J]. Dermatol Surg, 2015, 41(Suppl 1): S354-S357. doi:10.1097/dss.0000000000000558
[25] Lee A, Grummer SE, Kriegel D, et al. Hyaluronidase. Dermatol Surg[J]. 2010, 36(7): 1071-1077. doi: 10.1111/j.1524-4725.2010.01585.x
[26] 陈曦, 李珊珊, 赵露, 等.动脉溶栓治疗视网膜中央动脉阻塞Meta分析[J].山东大学耳鼻喉眼学报, 2020, 34(4): 28-34. doi: 10.6040 /j.issn.1673-3770.1.2020.057 CHEN Xi, LI Shanshan, ZHAO Lu, et al. Meta-analysis of arterial thrombolysis for central retinal artery obstruction[J]. Journal of Otolaryngology and Ophthalmology, Shandong University, 2020, 34(4): 28-34. doi: 10. 6040 /j.issn.1673-3770.1.2020.057
[27] Zhang LX, Lai LY, Zhou GW, et al. Evaluation of intraarterial thrombolysis in treatment of cosmetic facial filler-related ophthalmic artery occlusion[J]. Plast Reconstr Surg, 2020, 145(1): 42e-50e. doi:10.1097/prs.0000000000006313
[28] 刘雁庭, 姜奕, 张曦颖. 体外反搏治愈视网膜中央动脉阻塞一例[J]. 新疆钢铁, 1996(4): 10 LIU Yanting, JIANG Yi, ZHANG Xiying. A case of central retinal artery obstruction cured by extracorporeal counterpulsation[J]. Xinjiang Iron and Steel, 1996(4):10
[29] 廖瑞端,郭彦,张苗青,等.体外反搏早期治疗视网膜中央动脉阻塞1例[J]. 新医学, 1995(12): 641 LIAO Ruiduan, GUO Yan, ZHANG Miaoqing, et al. Early treatment of central retinal artery obstruction by extracorporeal counterpulsation in one case[J]. New Medicine, 1995(12): 641
[30] 黄红. 体外反搏治疗视网膜中央动脉阻塞二例[J].冶金医药情报,1993(5): 50 HUANG Hong. Two cases of central retinal artery obstruction treated with extracorporeal counterpulsation[J]. Metallurgical Medicine Information, 1993(5): 50
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[2] ObjectiveTo compare the effects of intra-arterial thrombolysis and traditional treatment in central retinal artery occlusion(CRAO). MethodsWe searched the Pubmed, Embase, Clinical.gov, CNKI, and Wan Fang databases for related studies that were published up to May , . We included clinical controls that compared intra-arterial thrombolysis and conventional treatment in CRAO. The random effect model and R software were used for data analysis. ResultsWe identified seven studies including CRAO patients. Meta-analysis results of two randomized controlled trials(RCTs)showed that there was no significant difference in visual acuity improvement between CRAO patients treated with arterial thrombolysis therapy and those with conventional therapy(RR: ., % confidence interval .-., P=.). Meta-analysis results of five cohort studies indicated that compared with conventional therapy, arterial thrombolysis therapy significantly improved visual acuity(RR: ., % confidence interval .-., P<.). The difference between thrombolysis therapy and conventional therapy may be caused by the different treatment time windows in patients. Concerning the adverse reactions after treatment, two RCTs and five cohort studies showed that the adverse reactions in the thrombolysis group are significantly higher than those in the conventional treatment group. ConclusionAlthough intra-arterial thrombolysis therapy has therapeutic potential in CRAO patients, there is still insufficient clinical evidence to prove its effectiveness and safety. Further studies with a large sample and high quality RCTs are required.. Intra-arterial thrombolysis for central retinal artery occlusion: a Meta-analysisCHEN Xi, LI Shanshan, ZHAO Lu, YOU Ran, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 28-34.
[3] SONG Zhiyuan, YI Hongliang, WANG Yang, YANG Yunlong. Phototriggered imine-cross-linked hydrogels with mitomycin C for prevention of vocal cord adhesion after cordectomy: a canine model [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 78-80.
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