April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Different angiographic findings of cosmetic facial filler-associated ophthalmic and retinal artery occlusion: Autologous fat vs. hyaluronic acid
Author Affiliations & Notes
  • Yong-Kyu Kim
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • Cheolkyu Jung
    Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • Se Joon Woo
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • Kyu Hyung Park
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • Footnotes
    Commercial Relationships Yong-Kyu Kim, None; Cheolkyu Jung, None; Se Joon Woo, None; Kyu Hyung Park, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 251. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Yong-Kyu Kim, Cheolkyu Jung, Se Joon Woo, Kyu Hyung Park; Different angiographic findings of cosmetic facial filler-associated ophthalmic and retinal artery occlusion: Autologous fat vs. hyaluronic acid. Invest. Ophthalmol. Vis. Sci. 2014;55(13):251.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To evaluate the angiographic features of cosmetic facial filler associated ophthalmic artery and its branches occlusion, thereby elucidate its pathophysiology.

 
Methods
 

We retrospectively reviewed 6 female patients who sustained ophthalmic artery and its branches occlusion after cosmetic filler injection (3 cases of hyaluronic acid and 3 cases of autologous fat) and underwent immediate cerebral angiography and intra-arterial thrombolysis. We compared fundus fluorescein angiographic and cerebral angiographic findings as well as clinical characteristics between two groups of patients with different filler substances.

 
Results
 

Those underwent fat injection showed visible emboli at main ophthalmic artery trunk on cerebral angiography, while hyaluronic acid injected group showed obstruction at posterior ciliary branch. Fundus fluorescein angiography showed that fat particles could reach the arterioles as well as large vessels. However in hyaluronic acid cases, perfusion delay was observed without definitely visible emboli. All three hyaluronic acid cases showed skin necrosis, while none in the fat cases. The cerebral angiographic findings also suggest that the angiographic runoff is diminished in the distal branches of internal maxillary arteries only in hyaluronic acid injected group.

 
Conclusions
 

The mechanism of arterial obstruction after cosmetic facial filler injection seems to be different according to the materials used. Autologous fat, due to its various sizes, induces multiple embolisms in both large and small vessels. However, hyaluronic acid, due to its small and uniform size, might obstruct distal branches of ophthalmic artery and induces perfusion delay. Furthermore, water absorption-volume expansion property of hyaluronic acid seems to cause elevation of distal intra-tissue pressure, which might impede normal blood flow from ophthalmic artery to its distal ends, resulting in higher rate of skin lesions.

 
Keywords: 550 imaging/image analysis: clinical  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×