Injection of a soft tissue filler for aesthetic purposes can result in arterial embolism and loss of vision. Severe cases can result in complete blindness.
Soft tissue filler may include:
(1) a dermal filler (hyaluronic acid, other)
(2) fat
High risk injection areas:
(1) periosteum layer of the glabellar region
(2) sub-superficial muscular aponeurotic system layer of the nasal dorsum
(3) nasolabial fold
Embolic patterns include:
(1) ophthalmic artery occlusion
(2) central retinal artery occlusion
(3) branch retinal artery occlusion
Clinical features:
(1) vision loss soon after the procedure
(2) variable signs of stroke (limb weakness, etc)
(3) variable skin ischemia
(4) pain
(5) variable ophthalmoplegia
(6) variable ptosis
