It reported on three patients who received an injection of one to three different dermal fillers in the forehead area followed by central retinal artery occlusion.
The injections released the substance into the external carotid vessel at such a high force that it flowed backward into the internal carotid and into the eye, wrote researchers Michelle V. Carle, MD, and colleagues from Retina-Vitreous Associates Medical Group in Los Angeles.
A man lost field vision one day after an injection of hyaluronic acid. A woman reported severe vision loss the day she received an injection of autologous fat into the high forehead. Following an injection of bovine collagen and polymethylmethylacrylate microspheres (Artefill, Suneva) in her forehead creases, a woman reported she could not see with her right eye.
“Any substance injected at high pressure into the oculofacial area, including the forehead, can result in occlusion of the central or branch retinal artery or the posterior ciliary circulation, both of which branch from the ophthalmic artery.”
“The risk is very, very low but the risk is not zero,” Dr. Carle said.
“I just worry that often risks are minimised, and when something bad happens, surprises everybody. You don’t want to be a fear monger, but… these areas of the face that we manipulate for a lot of cosmetic procedures are highly vascularised, and now the whole area around the eye has been reported to cause this,” she said.