Sudden vision loss and neurological deficits after facial hyaluronic acid filler injection.
Sudden vision loss and neurological deficits after facial hyaluronic acid filler injection.
复制标题
DOI：
10.1186/s42466-022-00203-x
复制
发表时间：
2022-07-18
影响因子：
--
通讯作者：
Strzelczyk, Adam
中科院分区：
文献类型：
--
作者：
Lucaciu, Alexandra;Samp, Patrick Felix;Hattingen, Elke;Kestner, Roxane-Isabelle;Davidova, Petra;Kohnen, Thomas;Rudolph, Jasmin;Dietz, Andreas;Steinmetz, Helmuth;Strzelczyk, Adam
关键词：
面部年轻化的美容设备的持续扩张未能揭示美容干预的内在风险。应仔细确保对美容填充剂注射和潜在后遗症（包括眼部和神经系统并发症）的所有风险的知情同意。我们提出了两例并发症后面部透明质酸填充剂注射。案例一：一名43岁女性在接受透明质酸（HA）填充物注射到左侧眉间区后，出现左眼单眼视力丧失、相关上睑下垂、眼肌麻痹、眼周疼痛和恶心、眉间区和前额皮肤变化以及左侧上颌分支皮区（V2）感觉障碍。在眼科检查中，根据“樱桃红点”的鉴定诊断为眼动脉闭塞（OAO）。磁共振成像（MRI）显示左侧缺血性视神经病变。开始支持治疗和透明质酸酶注射。就诊后两个月进行的头部随访MRI与稳定的MRI结果一致。患者左眼视力完全丧失，但上睑下垂消退。案例二：一名29岁的女性在接受鼻整形术和透明质酸脸颊填充术后几个小时入院，表现为右眼急性单眼视力丧失、球后疼痛、疲劳和呕吐。此外，患者出现了即将发生的皮肤坏死和右侧完全眼神经麻痹、脉络膜缺血和视力受损的先兆。开始支持性治疗和向缺血组织中注射透明质酸酶。随访时，鼻尖处的小疤痕、视力受损和右侧瞳孔边缘不规则持续存在。这两个病例报告和文献综述强调了导致潜在破坏性并发症的病理生理机制。为了减少继发于美容填充剂注射的视力丧失的风险，从业人员应具备解剖学和预防策略的全面知识。在线版本包含补充材料，可通过10.1186/s42466-022-00203-x获得。
The ongoing expansion of the cosmetic armamentarium of facial rejuvenation fails to uncover the inherent risks of cosmetic interventions. Informed consent to all risks of cosmetic filler injections and potential sequelae, including ocular and neurological complications, should be carefully ensured. We present two cases of complications following facial hyaluronic acid filler injections. Case 1: A 43-year-old woman presented with monocular vision loss of the left eye, associated ptosis, ophthalmoplegia, periocular pain and nausea, cutaneous changes of the glabella region and forehead, and sensory impairment in the left maxillary branch dermatome (V2) after receiving a hyaluronic acid (HA) filler injection into the left glabellar area. On ophthalmological examination, an ophthalmic artery occlusion (OAO) was diagnosed upon identification of a “cherry-red spot”. Magnetic resonance imaging (MRI) revealed a left ischemic optic neuropathy. Supportive therapy and hyaluronidase injections were initiated. A follow-up MRI of the head performed two months after presentation corresponded to stable MRI findings. The patient had irreversible and complete vision loss of the left eye, however, the ptosis resolved. Case 2: A 29-year-old woman was admitted to hospital a few hours after a rhinoplasty and cheek augmentation with hyaluronic acid, presenting with acute monocular vision loss in the right eye, retrobulbar pain, fatigue and vomiting. In addition, the patient presented a harbinger of impending skin necrosis and a complete oculomotor nerve palsy on the right side, choroidal ischemia and vision impairment. Supportive treatment and hyaluronidase injections into the ischemic tissue were initiated. A small scar at the tip of the nose, vision impairment and an irregular pupillary margin on the right side persisted at follow-up. These two case reports and the literature review emphasize the pathophysiological mechanisms leading to potentially devastating complications. In order to reduce the risk of vision loss secondary to cosmetic filler injections, practitioners should possess a thorough knowledge of anatomy and preventive strategies. The online version contains supplementary material available at 10.1186/s42466-022-00203-x.
登录
查看更多内容
影响因子：
2.9
作者：
Goodman, Greg J.;Magnusson, Mark R.;Kosenko, David E.
通讯作者：
Kosenko, David E.
影响因子：
39.3
作者：
Ibanez, Borja;James, Stefan;Zeymer, Uwe
通讯作者：
Zeymer, Uwe
影响因子：
2.4
作者：
Glogau, Richard G.;Kane, Michael A. C.
通讯作者：
Kane, Michael A. C.
影响因子：
2.4
作者：
Bachmann, Frank;Erdmann, Ricardo;Rzany, Berthold
通讯作者：
Rzany, Berthold
影响因子：
2.4
作者：
Glaich, AS;Cohen, JL;Goldberg, LH
通讯作者：
Goldberg, LH