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A case of severe ocular ischemia and impaired ocular motility immediately after injection of hyaluronic acid for cosmetic rhinoplaasty Eri Nishimura 1 , Hidetsugu Mori 1 , Kazuki Nakagawa 1 , Yuta Nakamichi 1 , Yoshimi Nagai 1 , Haruhiko Yamada 1 , Kanji Takahashi 1 1Department of Ophthalmology, Kansai Medical University pp.1153-1159
Published Date 2018/8/15
DOI https://doi.org/10.11477/mf.1410212792
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Abstract Purpose:To report a case who developed occlusion of ophthalmic artery and impaired ocular motility following injection of hyaluronic acid for augmentation rhinoplasty.

Case:A 31-year-old female was referred to us for severe loss of vision in the right eye immediately after cosmetic injection of hyaluronic acid to the root of her nose. Her visual acuity failed to improve after injection of hyaluronidase.

Findings and Clinical Course:Corrected visual acuity was 0.2 right and 1.5 left. The right eye showed absence of direct and indirect light reflex, upper lid edema and impaired adduction. Her right fundus showed opaque retina. Fluorescein angiography showed delayed dye inflow into the retina and the choroid. The right eye showed no direct and indirect light reflex. Optical coherence tomography angiography(OCTA)showed insufficient circulation in the retina and the choroid. Optical coherence tomography(OCT)showed thickening and hyperreflectivity of inner retinal layer in the right eye. Visual acuity was reduced to 20 cm counting fingers the following day. MRI showed thickening of extraocular muscles. The findings led to the diagnosis of occlusion of ophthalmic artery and inflammation of extraocular muscles. Visual acuity in the right eye improved to 0.2 one month later.

Conclusion:The present case illustrates that injection of hyaluronic acid to the nasal root may induce grave complictions due to involvement of ophthalmic artery.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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