Blindness Due to Hyaluronic Acid Filler Injection: A Case Report and Review of Literature

To Report a case of blindness due to hyaluronic acid filler injection.

 A 28-year-old female patient was referred to our clinic with complaints of vision loss in the left eye, which occurred one hour after hyaluronic acid filler injection for correction of detachment trough hollowness. In the ophthalmologic examination, relative afferent pupillary defect (RAPD) was positive in the left eye. Dilated fundus examination of the left eye revealed retinal edema and whitening in the inferotemporal macula consistent with a branch retinal artery occlusion. Cherry red spot was noticed in the central macula, along with scattered intraretinal hemorrhages. Fluorescein angiography demonstrated the blockage of the inferior branches of retinal circulation in the left eye and areas of patchy choroidal non-perfusion were revealed. Fluorescein angiography also demonstrated delayed filling in some of the proximal arteries in the left eye, but the pattern of filling was patchy. The Optical Coherence Tomography of the left eye demonstrated retinal inner layers edema starting just below the fovea. The patient underwent anterior chamber tap and ocular massage in primary hours of symptoms and, then, treatment with aspirin, systemic corticosteroid, acetazolamide, and nitroglycerin for one month. The visual acuity of the eye was No Light Perception (NLP) without any improvement after 3 days and even after 6 months after the treatment.

It is necessary to describe this complication, as well as its treatment process for patients, who undergo filler injection for cosmetic purposes. Additionally, the patients should be trained for an appropriate and prompt arrival with the least visual impairment.