J Korean Ophthalmol Soc.  2014 Aug;55(8):1253-1256.

A Case of Visual Loss Following Injection of Poly-(L)-Lactic Acid Filler into the Right Forehead

• Cho YW
• Chung IY
• Park JM
• Yoo JM
• Kim SJ
• Seo SW
• Han YS

Abstract

PURPOSE
We report a case of visual loss after the injection of poly-L-lactic acid filler into the right forehead area for cosmetic purposes.
CASE SUMMARY
A 46-year-old female patient visited our clinic due to sudden visual disturbance and dysesthesia on the right forehead and cheek. Her best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Visual acuity in her right eye was not corrected. An afferent papillary defect in the right eye and paralysis of oculomotor muscles were observed. Fundus exam revealed a pale optic nerve and turbid retina on the posterior pole. The retinal vessels were narrowed. A papule 1 cm to the lateral margin of the right eyebrow due to the needle injection was found and no other visible skin abnormalities were observed. She had a cosmetic poly-L-lactic acid filler injection into the right forehead area immediately before the visual disturbance occurred. Fluorescent angiography showed occlusion of the right retinal artery and blood flow defects on the retina and choroid were present. The patient was followed up for 6 months and visual acuity and dysesthesia in her right forehead and cheek did not improve.
CONCLUSIONS
Several cases of visual loss have occurred after injection of filler on the glabella and forehead for cosmetic purposes. However, most of the complications were observed after the use of hyaluronic fillers and not due to poly-L-lactic acid filler. This is the first case report of visual loss caused by poly-L-lactic acid filler in South Korea in a normal patient. Hence, consideration of complications when using this type of fillers is important.

Keyword

Filler; Poly-L-lactic acid; Visual loss

MeSH Terms

Angiography
Cheek
Choroid
Eyebrows
Female
Forehead*
Humans
Korea
Middle Aged
Needles
Oculomotor Muscles
Optic Nerve
Paralysis
Paresthesia
Retina
Retinal Artery
Retinal Vessels
Skin Abnormalities
Visual Acuity

Figure

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  Figure 1. Filler material is shown with right retinal artery occlusion.

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  Figure 2. Right ophthalmic artery occlusion is shown from fluorescein angiography.

Reference

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