미간에 히알루론산 필러 주입 후 발생한 전체 외안근마비를 동반한 시력소실 1예

• 영문명: A Case of Visual Loss and Ophthalmoplegia Following Injection of Hyaluronic Acid into the Glabella
• 발행기관: 대한안과학회
• 저자명: 백동원 장인범 김재석 이주화 최진,Dong Won Paik, MD, In Bum Jang, MD, Jae Suk Kim, MD, Joo Hwa Lee, MD, Jin Choi, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume54,number6, 971~976쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2013.06.15

영문 초록

Purpose: To report a case of sudden unilateral visual loss and total external ophthalmoplegia combined with multifocal brain infarction following injection of hyaluronic acid (Restylane; Q-Med AB, Uppsala, Sweden) into the glabella area. Case summary: A 25-year-old woman was referred for sudden unilateral visual loss and blepharoptosis. Visual acuity was no light perception in the right eye and 0.15 in the left eye. The best corrected visual acuity was no light perception in the right eye and 1.0 in the left eye. The right pupil was dilated and a relative afferent pupillary defect was detected. The patient showed blepharoptosis and total external ophthalmoplegia on the right side. Fundus examination revealed central retinal artery occlusion and pale disc in the right eye. The patient had developed skin necrosis and a surrounding reddish reticular pattern on her face around the glabella. She was injected with hyaluronic acid for 5 times into the glabella area. Fluorescein angiography of the right eye revealed markedly prolonged choroidal filling around the optic disc with no retinal arterial filling. Brain MRI showed multifocal punctuate acute infarction in both frontal lobes. After 2 months, ophthalmoplegia improved partially although her right eye vision did not, and 15 PD right exotropia was observed. Conclusions: Although most complications of dermal fillers are mild and transient, severe and persistent adverse effects can occur including tissue necrosis, retinal artery occlusion, and brain infarction. Therefore cosmetic procedures should be carefully performed when administering periocular dermal filler injection. A prompt consultation with an ophthalmologist is recommended when there is evidence of visual problems after injection.

키워드

Central retinal artery occlusion, External ophthalmoplegia, Filler, Hyaluronic acid