Abstract
PurposeTo describe a rare occurrence of acute vision loss and diffuse alveolar hemorrhage following a treatment of injectable gluteal cosmetic filler.Patient and methodsA 20-year-old female underwent a cosmetic injection of unknown components for gluteal augmentation. Within hours she developed progressive shortness of breath secondary to diffuse alveolar hemorrhage. She presented to ophthalmology 6 weeks later with a history of bilateral decreased vision. Clinical examination revealed cotton wool spots and retinal hemorrhages. Fluorescein angiography demonstrated macular vascular pruning and an enlarged foveal avascular zone.ResultsThe patient was observed and vision did not improve after 8 months of follow-up.ConclusionThese findings were attributed to a Purtscher-like retinopathy secondary to systemic inflammation induced by the filler and/or direct microembolization of the injected material or fat. To the best of the authors’ knowledge, this is the first documented case of diffuse alveolar hemorrhage and ischemic bilateral vision loss in a patient undergoing gluteal augmentation with dermal filler.
Highlights
Invasive cosmetic procedures are being performed with increasing frequency as a means to circumvent surgery
The patient suffered a precipitous drop in her hematocrit (35% to 20%) over the course of 48 hours. She was stabilized with adequate hydration, high dose steroids, and two blood transfusions. She presented to the ophthalmology clinic with a history of acute bilateral vision loss that began the day of the cosmetic injection
To the authors’ knowledge, this is the first reported case of soft tissue filler injection for gluteal enhancement leading to bilateral vision loss and diffuse alveolar hemorrhage
Summary
Invasive cosmetic procedures are being performed with increasing frequency as a means to circumvent surgery. This is the first reported case of acute bilateral vision loss and diffuse alveolar hemorrhage in the setting of cosmetic filler injection for gluteal augmentation. She presented to the ophthalmology clinic with a history of acute bilateral vision loss that began the day of the cosmetic injection. A: Fundus photograph of the right eye at presentation depicting cotton wool spots and intraretinal hemorrhages localized to the posterior pole.
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