Long-Term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection.

Abstract

BACKGROUND\nOphthalmic artery occlusion (OAO) and retinal artery occlusion (RAO) after facial filler injection have become increasingly significant due to the increment of cosmetic injection procedures for aesthetic purposes.\n\n\nOBJECTIVES\nTo analyze the long-term visual outcomes and complications of cosmetic facial filler related OAO and RAO.\n\n\nMETHODS\nThis single center, retrospective case series included 17 eyes of 16 filler related OAO or RAO patients with a follow-up period of one year or longer. Main outcome measures were best-corrected visual acuity (BCVA) and long-term complications.\n\n\nRESULTS\nThe mean age at diagnosis was 31.7 ± 9.7 years and all patients were female. The mean follow-up period was 5.4 ± 2.4 years. The mean BCVA was 2.34 and 2.41 logMAR at the initial and last visits, respectively, which indicates sustained long-term visual decrement. Ocular complications included retinal atrophy and degeneration (100.0%), optic atrophy and profound visual impairment (82.4%), strabismus (80.0%), retinal fibrous membrane (68.8%), posterior synechiae (35.3%), neovascularization (29.4%), iris atrophy and cataract (23.5%), corneal opacity and phthisis bulbi (17.6%), visual field defect and iris defect (11.8%), ophthalmoplegia (7.7%), and pupillary block (5.9%). Extra-ocular complications of brain infarction and depression were found in 25.0%, while skin necrosis was found in 13.3% of patients.\n\n\nCONCLUSIONS\nFacial filler related OAO or RAO resulted in long-term poor visual outcome, and most of the patients experienced irreversible visual impairment with no light perception despite various treatments. Various long-term ocular and extra-ocular complications were observed, which should be monitored for a long-term follow-up period. Our findings suggest that prevention should be stressed more than treatment.