Unilateral Blindness With Bilateral Brain Infarction After Cosmetic Facial Filler Injection.

Abstract

To describe a case of bilateral brain infarction associated with iatrogenic ophthalmic artery occlusion after cosmetic facial filler injection and to elucidate the pathogenic mechanism of bilateral brain infarction. Case report and review of the literature. A case of unilateral blindness due to iatrogenic ophthalmic artery occlusion accompanied by bilateral brain infarction after cosmetic facial filler injection is described. Fluorescein angiographic images demonstrate ischemia of the retina and choroid. Associated bilateral brain infarction was observed on MRI. Bilateral embolic events after facial filler injection are very rare. However, several cases of unilateral iatrogenic ophthalmic or retinal artery occlusion accompanied by bilateral brain infarction have been reported. The possible route of filler material to the contralateral cerebral artery is through the anterior communicating artery. Brain infarction, especially contralateral embolic events, should be considered in severe cases of iatrogenic ophthalmic artery occlusion after facial filler injection.