The Functional Anatomy of the Ophthalmic Angiosome and Its Implications in Blindness as a Complication of Cosmetic Facial Filler Procedures
Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However, blindness may be delayed for up to 2 weeks, sometimes following injection at remote sites, suggesting alternative pathways and pathogenesis....
Saved in:
Published in | Plastic and reconstructive surgery (1963) Vol. 146; no. 4; p. 745 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.10.2020
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However, blindness may be delayed for up to 2 weeks, sometimes following injection at remote sites, suggesting alternative pathways and pathogenesis.
Seeking solutions, fresh cadaver radiographic lead oxide injection, dissection, and histologic studies of the orbital and facial pathways of the ophthalmic angiosome, performed by the ophthalmic artery and vein, both isolated and together, and facial artery perfusions, were combined with total body archival arterial and venous investigations.
These revealed (1) arteriovenous connections between the ophthalmic artery and vein in the orbit and between vessels in the inner canthus, allowing passage of large globules of lead oxide; (2) the glabella, inner canthi, and nasal dorsum are the most vulnerable injection sites because ophthalmic artery branches are anchored to the orbital rim as they exit, a plexus of large-caliber avalvular veins drain into the orbits, and arteriovenous connections are present; (3) choke anastomoses between posterior and anterior ciliary vessels supplying the choroid and eye muscles may react with spasm to confine territories impacted with ophthalmic artery embolus; (4) true anastomoses exist between ophthalmic and ipsilateral or contralateral facial arteries, without reduction in caliber, permitting unobstructed embolus from remote sites; and (5) ophthalmic and facial veins are avalvular, allowing reverse flow.
The authors' study has shown potential arterial and venous pathways for filler embolus to cause blindness or visual field defects, and is supported clinically by a review of the case literature of blindness following facial filler injection. |
---|---|
AbstractList | Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However, blindness may be delayed for up to 2 weeks, sometimes following injection at remote sites, suggesting alternative pathways and pathogenesis.
Seeking solutions, fresh cadaver radiographic lead oxide injection, dissection, and histologic studies of the orbital and facial pathways of the ophthalmic angiosome, performed by the ophthalmic artery and vein, both isolated and together, and facial artery perfusions, were combined with total body archival arterial and venous investigations.
These revealed (1) arteriovenous connections between the ophthalmic artery and vein in the orbit and between vessels in the inner canthus, allowing passage of large globules of lead oxide; (2) the glabella, inner canthi, and nasal dorsum are the most vulnerable injection sites because ophthalmic artery branches are anchored to the orbital rim as they exit, a plexus of large-caliber avalvular veins drain into the orbits, and arteriovenous connections are present; (3) choke anastomoses between posterior and anterior ciliary vessels supplying the choroid and eye muscles may react with spasm to confine territories impacted with ophthalmic artery embolus; (4) true anastomoses exist between ophthalmic and ipsilateral or contralateral facial arteries, without reduction in caliber, permitting unobstructed embolus from remote sites; and (5) ophthalmic and facial veins are avalvular, allowing reverse flow.
The authors' study has shown potential arterial and venous pathways for filler embolus to cause blindness or visual field defects, and is supported clinically by a review of the case literature of blindness following facial filler injection. |
Author | Ashton, Mark W Corlett, Russell J Shoukath, Sajna Taylor, G Ian Gascoigne, Adam |
Author_xml | – sequence: 1 givenname: G Ian surname: Taylor fullname: Taylor, G Ian organization: From the Taylor Lab, Department of Anatomy and Neuroscience, and the Department of Surgery, University of Melbourne; the Plastic and Reconstructive Surgery Unit, The Royal Melbourne Hospital; and the Professorial Plastic Surgery Unit, Epworth Freemasons Hospital – sequence: 2 givenname: Sajna surname: Shoukath fullname: Shoukath, Sajna organization: From the Taylor Lab, Department of Anatomy and Neuroscience, and the Department of Surgery, University of Melbourne; the Plastic and Reconstructive Surgery Unit, The Royal Melbourne Hospital; and the Professorial Plastic Surgery Unit, Epworth Freemasons Hospital – sequence: 3 givenname: Adam surname: Gascoigne fullname: Gascoigne, Adam organization: From the Taylor Lab, Department of Anatomy and Neuroscience, and the Department of Surgery, University of Melbourne; the Plastic and Reconstructive Surgery Unit, The Royal Melbourne Hospital; and the Professorial Plastic Surgery Unit, Epworth Freemasons Hospital – sequence: 4 givenname: Russell J surname: Corlett fullname: Corlett, Russell J organization: From the Taylor Lab, Department of Anatomy and Neuroscience, and the Department of Surgery, University of Melbourne; the Plastic and Reconstructive Surgery Unit, The Royal Melbourne Hospital; and the Professorial Plastic Surgery Unit, Epworth Freemasons Hospital – sequence: 5 givenname: Mark W surname: Ashton fullname: Ashton, Mark W organization: From the Taylor Lab, Department of Anatomy and Neuroscience, and the Department of Surgery, University of Melbourne; the Plastic and Reconstructive Surgery Unit, The Royal Melbourne Hospital; and the Professorial Plastic Surgery Unit, Epworth Freemasons Hospital |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32590524$$D View this record in MEDLINE/PubMed |
BookMark | eNpNkN9KwzAUh4Mozk3fQCQv0HmSNk17OYvVwWBD5_XIv7pImpSmu9gz-NJ2qOjhB-fi43w_OFN07oM3CN0SmBMo-f3m5XUO_4YTxs7QFWG0TDKa0QmaxvgBQHias0s0SSkrgdHsCn1u9wbXB68GG7xweOHFENojDg0eRrLu9sNeuNaqkbzbEENrsPAaL4eIl23nrBKny4itxw_Oeu1NjFiMwVX44ydfFWJrhtFUC2XHqto6Z3q86YMy-tCbeI0uGuGiufnZM_RWP26r52S1flpWi1WiMiAsIQ0rKEDJSlpAnupGcZANBS1JUQCTkjZC8pRDk2vIVF6ygsiSq5wVhWQkpzN09-3tDrI1etf1thX9cff7FfoFW5Rlnw |
CitedBy_id | crossref_primary_10_1093_asjof_ojac012 crossref_primary_10_1093_asj_sjab003 crossref_primary_10_1093_asj_sjab334 crossref_primary_10_1016_j_jcms_2024_06_014 crossref_primary_10_1016_j_jtos_2023_04_005 crossref_primary_10_17116_plast_hirurgia202102167 crossref_primary_10_1097_SAP_0000000000002866 crossref_primary_10_1080_01676830_2022_2149818 crossref_primary_10_1097_PRS_0000000000010301 crossref_primary_10_1097_PRS_0000000000010212 crossref_primary_10_1111_jocd_14019 crossref_primary_10_3390_molecules27175398 crossref_primary_10_1093_asj_sjac227 crossref_primary_10_20340_mv_mn_2023_31_3__798 crossref_primary_10_1093_asj_sjae091 crossref_primary_10_1097_PRS_0000000000007913 crossref_primary_10_1016_j_bjps_2023_05_017 crossref_primary_10_1111_jocd_15646 crossref_primary_10_1016_j_adoms_2022_100367 crossref_primary_10_1097_PRS_0000000000009950 crossref_primary_10_1097_PRS_0000000000009876 crossref_primary_10_1177_03000605231194514 crossref_primary_10_1093_asj_sjac060 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1097/PRS.0000000000007155 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1529-4242 |
ExternalDocumentID | 32590524 |
Genre | Journal Article |
GroupedDBID | --- .-D .3C .55 .GJ .XZ .Z2 01R 0R~ 123 1CY 1J1 354 3EH 3O- 40H 4Q1 4Q2 4Q3 53G 5RE 5VS 71W 77Y 7O~ AAAAV AAAXR AAGIX AAHPQ AAIQE AAMOA AAMTA AAQKA AAQQT AARTV AASCR AASOK AASXQ AAUEB AAXQO ABASU ABBUW ABDIG ABJNI ABOCM ABVCZ ABXVJ ABZAD ACBNA ACCJW ACDDN ACEWG ACGFO ACGFS ACILI ACLDA ACNWC ACOAL ACWDW ACWRI ACXJB ACXNZ ADFPA ADGGA ADHPY ADNKB AE3 AE6 AEETU AENEX AFDTB AFFNX AFSOK AFUWQ AGINI AHOMT AHQNM AHRYX AHVBC AIJEX AINUH AJIOK AJNWD AJNYG AJZMW AKULP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AWKKM BOYCO BQLVK BS7 BYPQX C45 CGR CS3 CUY CVF DIWNM DU5 DUNZO E.X EBS ECM EEVPB EIF EJD ERAAH EX3 F2K F2L F2M F2N F5P FCALG FL- FW0 GNXGY GQDEL H0~ HLJTE HZ~ IKREB IKYAY IN~ IPNFZ J5H JF7 JF9 JG8 JK3 JK8 K8S KD2 KMI L-C L7B N4W N9A NPM N~7 N~B N~M O9- OAG OAH OBH OCUKA ODA OHH OHT OJAPA OL1 OLB OLG OLH OLU OLV OLW OLY OLZ OPUJH ORVUJ OUVQU OVD OVDNE OVIDH OVLEI OVOZU OWU OWV OWW OWX OWY OWZ OXXIT P-K P2P R58 RIG RLZ RXW S4R S4S T8P TAF TEORI TSPGW TWZ V2I VVN W3M WH7 WOQ WOW X3V X3W X7M XXN XYM YOC ZFV ZGI ZXP ZY1 ZZMQN |
ID | FETCH-LOGICAL-c4015-1f5820095928063dfc70bf20db18805bb2fab7370f6d04c69581b97c6588b5162 |
IngestDate | Wed Oct 16 00:45:16 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 4 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c4015-1f5820095928063dfc70bf20db18805bb2fab7370f6d04c69581b97c6588b5162 |
PMID | 32590524 |
ParticipantIDs | pubmed_primary_32590524 |
PublicationCentury | 2000 |
PublicationDate | 2020-10-00 |
PublicationDateYYYYMMDD | 2020-10-01 |
PublicationDate_xml | – month: 10 year: 2020 text: 2020-10-00 |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Plastic and reconstructive surgery (1963) |
PublicationTitleAlternate | Plast Reconstr Surg |
PublicationYear | 2020 |
SSID | ssj0017365 |
Score | 2.4953747 |
Snippet | Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However,... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 745 |
SubjectTerms | Blindness - etiology Cadaver Cosmetic Techniques - adverse effects Dermal Fillers - adverse effects Embolism - complications Embolism - etiology Face - blood supply Humans Ophthalmic Artery - anatomy & histology Ophthalmic Artery - physiology |
Title | The Functional Anatomy of the Ophthalmic Angiosome and Its Implications in Blindness as a Complication of Cosmetic Facial Filler Procedures |
URI | https://www.ncbi.nlm.nih.gov/pubmed/32590524 |
Volume | 146 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ZT9tAEF4FKiFeEL1pSzUPvEWm62O98WNaEQ4JighIvKFdHySU2FGc9KF_gR_HX-rs4SOUVpTIsiJvsrI8n-f4dmaWkB3fRzuQUuZESUydgEnPiVSOuzIm3JOi52oe8vgkPLgIji7ZZadz38paWszlbvzr0bqS50gVr6FcVZXsf0i2nhQv4HeUL55Rwnh-sowHaJgsn9fPMYI21SHKnfw-Hc1H4lYlv_fz63FRFhOzVnA4L3VX4HYm-Vd0NxOt9gQeWk1U4zpjoygnqtyxOxCaYx_oEkJTZpAsZjYR0Tq5p-iRV31gdcBtm9T-TLulqcLW7aHwpWzxEA11sN89bCA7HBWLH8KQP0Nxk9dWZF-UcTG-toRsIib1akoxu7XJx2eLslTc5FGb28BAtsqSQ9Nk9bEXOYEXLCtsS1qO23SEVr_ctKb8wyyYdsOnZ0PTrtJ-uMuWfo7CnU40VHwMCikzxd3_Hn3QrLsaWiErvKd2EjlR5JFd1OJ-yKrqzYh_eex21slaNcWDOEf7O-ebZMMGKtA3qHtJOmn-iqwd21SM1-QOwQcN-MCCD4oMEHzQgA9q8AECAhB80AYfjHOowQcCD2iDT81XgQ8M-MCADxrwvSEXg73zbweO3dnDiTGeR02QsZ6nm2KrhX0_yWJOZebRRKr2gExKLxOS-5xmYUKDOIwYRlcRj9Fd7knmht5bspoXefqegMvdGINiyoXggaRqF71I4N8wUqZhJOQWeWce49XUtG-5qh7wh7-OfCTrDRo_kRcZ6ot0G53PufysRfobknaCyg |
link.rule.ids | 780 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+Functional+Anatomy+of+the+Ophthalmic+Angiosome+and+Its+Implications+in+Blindness+as+a+Complication+of+Cosmetic+Facial+Filler+Procedures&rft.jtitle=Plastic+and+reconstructive+surgery+%281963%29&rft.au=Taylor%2C+G+Ian&rft.au=Shoukath%2C+Sajna&rft.au=Gascoigne%2C+Adam&rft.au=Corlett%2C+Russell+J&rft.date=2020-10-01&rft.eissn=1529-4242&rft.volume=146&rft.issue=4&rft.spage=745&rft_id=info:doi/10.1097%2FPRS.0000000000007155&rft_id=info%3Apmid%2F32590524&rft_id=info%3Apmid%2F32590524&rft.externalDocID=32590524 |