1. From: Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler InjectionsA National Survey by the Korean Retina Society
JAMA Ophthalmol. 2014;132(6): doi: /jamaophthalmol
Figure Legend:
Ophthalmic Artery OcclusionA 36-year-old woman (patient 15) after autologous fat injections in the glabella and nasolabial fold. A, Fundus photograph obtained at the initial visit shows diffuse retinal edema and multiple segmented retinal arteries with fat emboli. B and C, Retinal and choroidal perfusion is severely diminished. D, Electroretinography (ERG) shows markedly reduced cone and rod responses. E, Multifocal acute infarction in the left middle cerebral artery territories on diffusion-weighted brain magnetic resonance imaging. F, Three months later, a retinal fibrous scar associated with optic atrophy was observed. The initial and final visual acuity in the left eye was no light perception.
Date of download: 10/16/2017

2. From: Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler InjectionsA National Survey by the Korean Retina Society
JAMA Ophthalmol. 2014;132(6): doi: /jamaophthalmol
Figure Legend:
Posterior Ischemic Optic NeuropathyA 27-year-old woman (patient 44) after hyaluronic acid injections in the glabella and nasal dorsum for rhinoplasty. A, Fundus photograph obtained at the initial visit shows normal retina and optic disc appearance. B, A fluorescein angiogram shows normal retinal perfusion. C, An indocyanine green angiogram shows normal choroidal perfusion. D, Three months later, the optic disc has a temporal pallor. E, Optical coherence tomography reveals normal retinal structure. F, Electroretinographic (ERG) findings are normal in both eyes and symmetric. G, Goldmann perimetry reveals a small remnant island in the nasal area. H, Visual evoked response (VER) shows delayed latency and reduced amplitude in the right eye. I, No definitive evidence of intraorbital trauma (eg, orbital wall fracture, hemorrhage) or acute brain parenchyma lesions are found on T2-weighted magnetic resonance imaging. J, Diffusion-weighted magnetic resonance imaging shows a focal high–signal intensity lesion in the retrobulbar optic nerve of the right eye (yellow arrowhead).
Date of download: 10/16/2017

3. From: Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler InjectionsA National Survey by the Korean Retina Society
JAMA Ophthalmol. 2014;132(6): doi: /jamaophthalmol
Figure Legend:
Schematic Drawing of the Ophthalmic Artery, Its Branches, and Possible Obstruction PointsInjected filler material (yellow droplet) is presumed to access the ophthalmic artery retrogradely via the supratrochlear, supraorbital, or dorsal nasal artery. Ophthalmic artery occlusion (OAO) is likely caused by complete proximal ophthalmic artery obstruction by a large filler bolus that migrated backward from the high injection pressure. It may also be that small particles migrated back to the central retinal artery and posterior ciliary artery origins and dispersed anterogradely into each branch as injection pressure decreased. This would cause a diffuse obstruction. Generalized posterior ciliary artery occlusion (GPCAO) or central retinal artery occlusion (CRAO) may occur depending on the extent of central retinal artery or posterior ciliary artery obstruction. When only the medial short posterior ciliary artery is involved, localized posterior ciliary artery occlusion (LPCAO) involving only the nasal choroid occurs. When only a branch of the central retinal artery is occluded, a branch retinal artery occlusion (BRAO) occurs. The mechanism of posterior ischemic optic neuropathy (PION) remains uncertain. The pial vascular plexus supplies blood to the intraorbital posterior optic nerve, and some vessels responsible for the pial plexus, which usually arise directly from the ophthalmic artery, might also be involved in these cases. Last, some particles may have accessed the internal carotid artery, causing a brain infarction. SNUBH indicates Seoul National University Bundang Hospital.
Date of download: 10/16/2017