Superselective Arterial Hyaluronidase Thrombolysis Is Not an Effective Treatment for Hyaluronic Acid-Induced Retinal Artery Occlusion: Study in a Rabbit Model.

Abstract

BACKGROUND:

Worldwide application of hyaluronic acid has brought about severe complications, including central retinal arterial occlusion, which leads to a deleterious effect on vision. The current study explored the efficacy of superselective arterial hyaluronidase thrombolysis in rabbit retinal artery occlusion induced by hyaluronic acid.

METHODS:

Occlusion of the internal/external ophthalmic artery in New Zealand White rabbits was induced with superselective injection of hyaluronic acid. Superselective subtraction angiography and fundus examination were conducted to confirm and evaluate the artery embolism. After 30 minutes of embolism, hyaluronidase was injected in the occluded artery through superselective arterial intubation.

RESULTS:

Compared with preoperative and contralateral eyes, the postoperative eyes showed the symptoms of central retinal arterial occlusion and embolization, confirmed by digital subtraction angiography. After intraarterial hyaluronidase thrombolysis, the embolization failed to dissolve as shown on funduscopic and angiographic examinations.

CONCLUSIONS:

Superselective ophthalmic artery intervention could accurately and successfully establish the animal models of retinal artery occlusion induced by hyaluronic acid. The precise occlusion site of the retinal artery and complete embolism were confirmed by ophthalmologic examinations. Intraarterial hyaluronidase thrombolysis might not be an effective method to treat retinal artery occlusion induced by hyaluronic acid.

• Authors: Jiabao Chen, Jiyin Ruan, Wei Wang, Zaizhong Chen, Qinying Huang, Yatong Yang, Jinying Li
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 147 Issue 1 Pg. 69-75 (01 01 2021) ISSN: 1529-4242 [Electronic] United States
• PMID: 33370052 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 by the American Society of Plastic Surgeons.

Chemical References

• Dermal Fillers
• Hyaluronic Acid
• Hyaluronoglucosaminidase
• Urokinase-Type Plasminogen Activator

Topics

• Angiography, Digital Subtraction
• Animals
• Cosmetic Techniques (adverse effects)
• Dermal Fillers (administration & dosage, adverse effects)
• Disease Models, Animal
• Humans
• Hyaluronic Acid (administration & dosage, adverse effects)
• Hyaluronoglucosaminidase (administration & dosage)
• Injections, Intra-Arterial
• Injections, Subcutaneous (adverse effects)
• Ophthalmic Artery (diagnostic imaging, drug effects)
• Rabbits
• Retinal Artery Occlusion (chemically induced, diagnosis, drug therapy)
• Thrombolytic Therapy (adverse effects, methods)
• Treatment Outcome
• Urokinase-Type Plasminogen Activator