Light Perception Vision Recovery After Treatment for Calcium Hydroxylapatite Cosmetic Filler-Induced Blindness.

Abstract	A 51-year-old woman presented with no light perception vision of the right eye 12 hours after another provider injected calcium hydroxylapatite into the glabella and dorsum of the nose. Exam and fluorescein angiography demonstrated optic nerve edema and choroidal hypoperfusion consistent with ischemia of the posterior ciliary circulation. The central retinal circulation appeared intact. One thousand two hundred units of retrobulbar hyaluronidase were injected urgently in several boluses. Oral prednisone and aspirin also were administered. Ocular massage was also initiated. One day later, visual acuity improved to light perception that remained stable at 3 months. Retrobulbar hyaluronidase injection, ocular massage, prednisone, and aspirin were correlated to recovery of light perception vision in this case of calcium hydroxylapatite filler embolization to the choroidal circulation. The mechanism for the recovery of some vision and the role of hyaluronidase and other medications remain uncertain. Further research in treatments for ophthalmic complications of facial fillers is warranted.
Authors	Priscilla Q Vu, Seanna R Grob, Jeremiah P Tao
Journal	Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2018 Nov/Dec Vol. 34 Issue 6 Pg. e189-e192 ISSN: 1537-2677 [Electronic] United States
PMID	30234833 (Publication Type: Case Reports, Journal Article)
Chemical References	Biocompatible Materials Durapatite Hyaluronoglucosaminidase
Topics	Biocompatible Materials (administration & dosage, adverse effects) Blindness (diagnosis, drug therapy, etiology) Cosmetic Techniques (adverse effects) Durapatite (administration & dosage, adverse effects) Female Fluorescein Angiography Follow-Up Studies Fundus Oculi Humans Hyaluronoglucosaminidase (administration & dosage) Injections Injections, Intraocular Magnetic Resonance Angiography Middle Aged Nose Recovery of Function Tomography, Optical Coherence Visual Acuity (physiology) Visual Perception (physiology)

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