Cargando…
Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection
BACKGROUND: To report a rare case of pulmonary and ocular complications with visual loss due to bilateral Purtscher-like retinopathy and paracentral acute middle maculopathy (PAMM) following a hyaluronic acid (HA) filler injection to the breast. Systemic and visual recovery was attained following co...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629129/ https://www.ncbi.nlm.nih.gov/pubmed/37932684 http://dx.doi.org/10.1186/s12886-023-03186-8 |
_version_ | 1785131899900919808 |
---|---|
author | Pee, Xu Kent Low, Adeline Ab Kahar, Mas Edi Putriku Intan Mohamed, Shelina Oli Chong, Ying-Jiun |
author_facet | Pee, Xu Kent Low, Adeline Ab Kahar, Mas Edi Putriku Intan Mohamed, Shelina Oli Chong, Ying-Jiun |
author_sort | Pee, Xu Kent |
collection | PubMed |
description | BACKGROUND: To report a rare case of pulmonary and ocular complications with visual loss due to bilateral Purtscher-like retinopathy and paracentral acute middle maculopathy (PAMM) following a hyaluronic acid (HA) filler injection to the breast. Systemic and visual recovery was attained following corticosteroid therapy. CASE PRESENTATION: A 27-year-old lady presented with painless blurring of vision in both eyes for 2 weeks following hyaluronic acid breast filler injections by a non-medical practitioner. She was initially admitted to the medical ward for diffuse alveolar haemorrhage and altered sensorium. The presenting visual acuity was counting fingers in both eyes. Bilateral dilated fundus examination showed hyperaemic discs, concentric rim of retinal whitening around macula with patches of polygonal-shaped retinal whitening, generalised cotton-wool spots, tortuous veins, and flame-shaped haemorrhages. Spectral-domain optical coherence tomography (SD-OCT) macula revealed hyper-reflective bands at the inner nuclear layer (INL). Fluorescein angiography demonstrated hot discs, delayed arm-to-retina time, arterial filling, and arterio-venous transit time with staining of the vessels at the posterior pole. She was managed with a tapering dose of systemic corticosteroids. The visual acuity improved to 6/12 over 8 weeks with significant anatomical and functional improvement. Dilated fundus examination showed resolution of initial funduscopy findings. The hyper-reflective bands on the OCT had resolved with subsequent thinning of the INL and disorganisation of retinal inner layers. CONCLUSION: Filler injections are in increasing demand and are frequently being performed by non-medical practitioners. Visual loss from non-facial HA fillers is rare. Inadvertent entry of HA into a blood vessel may potentially cause systemic and sight-threatening ocular complications. Good anatomical knowledge and proper injection technique are vital in preventing this unfortunate sequela. There are limited reports on successful visual recovery following various treatment approaches and we hope this case provides valuable insights. |
format | Online Article Text |
id | pubmed-10629129 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106291292023-11-08 Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection Pee, Xu Kent Low, Adeline Ab Kahar, Mas Edi Putriku Intan Mohamed, Shelina Oli Chong, Ying-Jiun BMC Ophthalmol Case Report BACKGROUND: To report a rare case of pulmonary and ocular complications with visual loss due to bilateral Purtscher-like retinopathy and paracentral acute middle maculopathy (PAMM) following a hyaluronic acid (HA) filler injection to the breast. Systemic and visual recovery was attained following corticosteroid therapy. CASE PRESENTATION: A 27-year-old lady presented with painless blurring of vision in both eyes for 2 weeks following hyaluronic acid breast filler injections by a non-medical practitioner. She was initially admitted to the medical ward for diffuse alveolar haemorrhage and altered sensorium. The presenting visual acuity was counting fingers in both eyes. Bilateral dilated fundus examination showed hyperaemic discs, concentric rim of retinal whitening around macula with patches of polygonal-shaped retinal whitening, generalised cotton-wool spots, tortuous veins, and flame-shaped haemorrhages. Spectral-domain optical coherence tomography (SD-OCT) macula revealed hyper-reflective bands at the inner nuclear layer (INL). Fluorescein angiography demonstrated hot discs, delayed arm-to-retina time, arterial filling, and arterio-venous transit time with staining of the vessels at the posterior pole. She was managed with a tapering dose of systemic corticosteroids. The visual acuity improved to 6/12 over 8 weeks with significant anatomical and functional improvement. Dilated fundus examination showed resolution of initial funduscopy findings. The hyper-reflective bands on the OCT had resolved with subsequent thinning of the INL and disorganisation of retinal inner layers. CONCLUSION: Filler injections are in increasing demand and are frequently being performed by non-medical practitioners. Visual loss from non-facial HA fillers is rare. Inadvertent entry of HA into a blood vessel may potentially cause systemic and sight-threatening ocular complications. Good anatomical knowledge and proper injection technique are vital in preventing this unfortunate sequela. There are limited reports on successful visual recovery following various treatment approaches and we hope this case provides valuable insights. BioMed Central 2023-11-07 /pmc/articles/PMC10629129/ /pubmed/37932684 http://dx.doi.org/10.1186/s12886-023-03186-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Pee, Xu Kent Low, Adeline Ab Kahar, Mas Edi Putriku Intan Mohamed, Shelina Oli Chong, Ying-Jiun Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title | Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title_full | Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title_fullStr | Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title_full_unstemmed | Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title_short | Purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
title_sort | purtscher-like retinopathy and paracentral acute middle maculopathy following breast filler injection |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629129/ https://www.ncbi.nlm.nih.gov/pubmed/37932684 http://dx.doi.org/10.1186/s12886-023-03186-8 |
work_keys_str_mv | AT peexukent purtscherlikeretinopathyandparacentralacutemiddlemaculopathyfollowingbreastfillerinjection AT lowadeline purtscherlikeretinopathyandparacentralacutemiddlemaculopathyfollowingbreastfillerinjection AT abkaharmasediputrikuintan purtscherlikeretinopathyandparacentralacutemiddlemaculopathyfollowingbreastfillerinjection AT mohamedshelinaoli purtscherlikeretinopathyandparacentralacutemiddlemaculopathyfollowingbreastfillerinjection AT chongyingjiun purtscherlikeretinopathyandparacentralacutemiddlemaculopathyfollowingbreastfillerinjection |