Efficacy of Single Intra-articular 2% Sodium Hyaluronate versus Corticosteroid Injection in Isolated Patellofemoral Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

To describe in-office suprachoroidal viscopexy (SCVEXY) as a novel adjunct surgical technique with pneumatic retinopexy (PnR) for rhegmatogenous retinal detachment (RRD). A 61-year-old pseudophakic man who was failing PnR for a macula-involving RRD underwent rescue SCVEXY at St. Michael's Hospital, Unity Health Toronto, Toronto, Canada. An injection of suprachoroidal sodium hyaluronate 2.3% (Healon 5, Johnson & Johnson Vision) was performed at five o'clock under the causative retinal tear using a 30 G needle with a custom-made guard that exposed 1 mm of the needle. Following the procedure, a dome-shaped suprachoroidal convexity was present in the inferotemporal quadrant. The patient achieved complete reattachment over 2 days with continued positioning. Laser retinopexy was applied around the causative tear, and the viscoelastic reabsorbed over a period of approximately 2 weeks. The retina remained attached until the final follow-up at 9 months. Suprachoroidal viscopexy (SCVEXY) is a minimally invasive in-office procedure that creates a temporary suprachoroidal buckle that can be used to rescue failing PnR in RRD. It can be particularly useful to close inferior tears, avoiding the need for operating room procedures such as pars plana vitrectomy or scleral buckle. However, there are still limited data on ideal case selection, efficacy, adverse events, and failure rates.

Penile augmentation procedures are controversial, primarily because most men seeking these interventions have penile dimensions within the normal range, and due to the associated risks of severe complications. This narrative review explores the effects of foreign body implantations and injections in the penis. Retrospective case series reveal the use of unapproved oil-based substances injected in non-sterile conditions, leading to sclerosing lipogranuloma and requiring complex treatments such as tissue excision and skin transplantation. The prevalence of this practice is unknown. Retrospective reports of foreign body implantation for enhancing sexual pleasure highlight complications such as pain, erosion, inflammation, nodules, skin ulcer, necrosis, penile deformity, gangrene and even death. In contrast, prospective studies on Hyaluronic acid filler injections show that these are better tolerated, however the follow-up period is short. Retrospective series of graft implantation reported improvement in penile girth and patient satisfaction; however, it had a negative impact on penile length. Silicone implants, examined in prospective cohorts carry risks of infection, erosion, seroma and necrosis, resulting in some cases of severe penile deformities and are associated with a removal rate of up to 10%. A multidisciplinary approach is essential for men requesting penile augmentation, and further research is needed to successfully manage patients seeking these procedures.

Background:Initial and early swelling post injection of hyaluronic acid (HA) filler are considered to affect outcomes and complications in patients; however, the contribution of HA filler type to swelling postinjection remains undetermined. Here, initial and early swelling post injection of HA fillers manufactured via different crosslinking technologies was evaluated in mice.Methods:Mice received injections of HA fillers or controls: High Concentration Equalized (HICE), Stabilized High Concentration Equalized (S-HICE), High molecular Ideal, VYCROSS, NASHA, HICE control, non-HICE control, or no HA control. Initial and early swelling were evaluated via magnetic resonance imaging and collagen deposition via histological evaluation over 28 days.Results:Mice (N = 65) were allocated to 13 groups (per group, n = 5) to receive subcutaneous injections of HA filler or control. Maximum swelling in descending order was High molecular Ideal, 290%; non-HICE control, 256%; VYCROSS 1, 249%; S-HICE 2, 248%; S-HICE 1, 238%; S-HICE 3, 226%; VYCROSS 2, 210%; HICE 1, 203%; HICE 2, 184%; NASHA 1, 174%; HICE control, 159%; NASHA 2, 148%; and no HA control, 100.0%. The mean (SD) collagen area in the residual substance ranged from 2525 (3612) µm2/HPF (high-power field [×400]) for NASHA 2 to 18,870 (4544) µm2/HPF for S-HICE 2. The mean (SD) collagen area around the substance ranged from 9879 (2923) µm2/HPF for VYCROSS 1 to 15,248 (7005) µm2/HPF for S-HICE 3.Conclusions:HA fillers manufactured via different crosslinking technologies may lead to different levels of initial and early swelling and collagen stimulation over 28 days.

Background:Cross-linked hyaluronic acid dermal fillers are being used increasingly for aesthetic enhancements, including lip enhancement, cheekbone augmentation, and nasolabial fold improvement. This study aimed to assess the safety and performance of a newly introduced dermal filler across different skin types.Methods:This is a prospective, single-arm clinical study that evaluates the safety and effectiveness of cross-linked sodium hyaluronate injection in patients undergoing treatment for facial wrinkles and lip enhancement. Participants underwent assessments at baseline; immediately at postoperative day 0; and at 3 months, 6 months, and 1 year after the procedure. The safety and effectiveness were evaluated through physical examinations, wrinkle severity ratings, full face global aesthetic assessments, cheekbone augmentation, nasolabial fold severity, and lip enhancement evaluations.Results:The study cohort included 122 participants, 41 men and 81 women, predominantly with Fitzpatrick skin types 3 (59%) and 4 (41%). Physical examinations revealed a significant reduction in facial wrinkles, with 81.14% (left side) and 84.42% (right side) of patients showing no wrinkles after 1 year. Full face aesthetic improvements were noted, with 36.88% of patients being “very much improved.” Cheekbone augmentation showed no wrinkles in 55.74% of patients (left side) and 72.13% (right side) at 1 year. Nasolabial fold severity decreased most significantly between 6 months and 1 year.Conclusions:The novel cross-linked hyaluronic acid dermal filler is safe and effective for enhancing lips, augmenting cheekbones, and improving nasolabial folds across various skin types. Significant improvements were observed in wrinkle severity, overall facial aesthetics, and specific enhancement areas.

Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas (KORTUC) is a novel radiosensitizing treatment developed in Japan that involves intratumoral injections of hydrogen peroxide (H2O2) and sodium hyaluronate (HA). KORTUC II, an evolved form of the therapy, aims to enhance radiotherapy efficacy by locally increasing oxygen tension and inhibiting antioxidant enzymes in the tumor microenvironment. This study retrospectively evaluated the safety and efficacy of KORTUC-based breast-conserving therapy (KORTUC-BCT) in patients with stage 0-IIIC primary breast cancer who refused standard treatment protocols. A total of 50 patients who underwent KORTUC-BCT between February 2013 and April 2022 and had at least 1 year of follow-up were included. Radiotherapy consisted of short-course tangential irradiation at a dose of 44 Gy in 16 fractions. For patients with lymph node metastases, the supraclavicular region was included in the radiation field. A boost dose of 9–12 Gy was subsequently delivered to the tumor using electron-beam radiation therapy. The H2O2/HA sensitizer was intratumorally injected twice weekly under ultrasound guidance. All patients achieved a clinical complete response within a median evaluation time of 12 months. The 3-year local control rate for all cases was 89.3%; by stage, it was 100% for 0-I, 100% for IIA, 53.3% for IIB, 75% for IIIA, 75.0% for IIIB and 100% for stage IIIC. The 3-year disease-free survival rate was 75% overall; by stage, it was 100% for 0-I, 91.7% for IIA, 53.3% for IIB, 60.0% for IIIA, 75.0% for IIIB and 20.0% for IIIC. Lymph node metastasis sites had a 100% 3-year control rate. No grade ≥3 adverse events or cosmetic complications were observed. These findings suggest that KORTUC-BCT is a minimally invasive and well-tolerated therapy with promising outcomes, particularly for patients with early-stage breast cancer who decline surgery. This clinical study was registered in the UMIN clinical trials registry (UMIN000003734; June 10, 2010).

Conservative treatment of trigger thumb and first carpometacarpal osteoarthritis include activity modification, nonsteroidal antiinflammatory drugs, splinting, steroid injection, hyaluronate injection and surgical intervention. These case reports describe the clinical treatment and rehabilitation of three patients, one with a trigger thumb and two with first carpometacarpal osteoarthritis, who were treated with adductor pollicis myofascial treatment. Treatment included trigger point dry needling, myofascial massage and a therapeutic stretching home program. The patients responded to intervention and returned to painless function after follow-up. There were no untoward side effects. This paper introduces a new method of management of thumb pain using myofascial therapeutic treatments for the adductor pollicis.

Using hyaluronic acid dermal fillers for nonsurgical augmentation of the nose has gained popularity during the past several years. However, this procedure is known to pose a high risk for vascular complications. In this report, we present the case of a 39-year-old woman who underwent a liquid rhinoplasty and experienced a vascular complication that was further complicated by a presumed allergic reaction following the administration of reversal agents.

A 31-year-old female presented with an acute onset of vision loss in the OS. On arrival to the hospital, OS ocular vitals were notable for no light perception vision, relative afferent pupillary defect, elevated intraocular pressure, ophthalmoplegia, and ptosis. Interval history was notable for lip filler injection. Emergent neuroimaging did not demonstrate large vessel occlusion. Ophthalmic artery occlusion resulting in orbital infarction syndrome was suspected. Patient received intravenous solumedrol, verapamil, aspirin, and lateral canthotomy/cantholysis, topical and intravenous antibiotics, and periorbital and orbital injections of hyaluronidase. With improvement in ptosis and extraocular motility, but vision remaining no light perception, the patient was discharged 5 days after presentation. However, a month later, the patient was enucleated due to intractable pain. This is the foremost report of orbital ischemic syndrome in the setting of ophthalmic artery occlusion secondary to hyaluronic acid filler injection to the lip.

Background/Objectives: Tendinopathies represent a prevalent musculoskeletal condition characterized by load-dependent pain, stiffness, weakness, and impaired functionality. Current treatment includes therapeutic exercise, physical modalities and injective therapy. Hyaluronic acid (HA) is a fundamental component of the extracellular matrix and plays a crucial role in tissue hydration, elasticity, and lubrication. This study aims to evaluate the effectiveness of ultrasound-guided injections of HA in improving pain symptoms and functionality in patients with supraspinatus tendinopathy. Methods: Patients with a confirmed diagnosis of supraspinatus tendinopathy, verified through ultrasound imaging, were included in the study. Patients underwent 3 ultrasound guidance injections (1/week) of Sodium Hyaluronate (Hyalotend, 20 mg/2 mL). Patients were evaluated at the baseline, 1 month (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after the first injection through the VAS, the QuickDASH and the SF-12. Results: Twenty-four patients were enrolled. As regards the VAS there was a statistically significant reduction (p < 0.01) of averages of values over time. The scores collected through the QuickDASH questionnaire have a statistically significant variation over time (p < 0.001). The values collected through the SF-12 Mental Component Summary (MCS) questionnaire show a highly statistically significant variation over time (p < 0.005). The values collected through the SF-12 Physical Component Summary (PCS) questionnaire show a statistically highly significant change over time (p < 0.001). Conclusions: Our results suggest that HA (Hyalotend) injections could represent a viable therapeutic option for patients with supraspinatus tendinopathy in the short, medium, and long term. Further studies with larger patient samples and a control group are needed to better investigate the effects and the modalities of administration of HA in tendinopathies.

The increased demand for non-surgical rhinoplasty using hyaluronic acid (HA) has given impetus to explore more injection techniques and has also placed a higher demand on the coping of complications. The purpose of this systematic review is to provide clinicians with recommendations by broadly consolidating data on HA injections for rhinoplasty injection techniques and complications, and presenting the advantages and disadvantages of each technique and the treatment of complications. A systematic electronic literature search using keywords and MESH search terms over the PubMed/Medline, Cochrane Central, Embase, Web of Science, and CNKI online databases was conducted from 2000 to 2024. Risk of bias assessment was performed for all included articles. There were 37 papers with a total of 7339 patients included in the study. Four different injection regimens were summarized. The incidence of serious complications such as blindness, skin necrosis, and cerebral infarction was only 3‰. Mild complications including bruising, hematoma, edema, and asymmetry had a higher incidence of 13.34%. Existing techniques for hyaluronic acid nasal injections can be summarized as top-to-bottom approach, bottom-up approach, critical site injections, and multi-plane injections, with the latter two more innovative injections reporting higher complication rates in comparison. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

In recurrent gynecologic malignancies following prior pelvic irradiation, definitive radiation therapy is often precluded by cumulative dose constraints to adjacent organs at risk (OARs), and patients may be left with only highly invasive surgical options such as total pelvic exenteration. While some institutions have explored displacement techniques such as artificial ascites or hyaluronic acid gel injection, these approaches are not widely adopted and frequently fail to ensure consistent and stable separation of OARs. We report the first clinical use of Neskeep®, a bioabsorbable polyglycolic acid (PGA) spacer, in high-dose-rate (HDR) brachytherapy for recurrent cervical cancer after prior pelvic radiation. A woman in her 40s with prior hysterectomy and HDR brachytherapy for cervical intraepithelial neoplasia grade III developed vaginal stump recurrence 4 years later. Laparoscopic placement of the PGA spacer was performed to achieve durable displacement of the small bowel, followed by eight fractions of HDR brachytherapy. Hyaluronic acid gel was also injected during each fraction to displace the bladder and rectum. The spacer maintained position and volume throughout treatment without complications. Dose–volume analysis showed a marked reduction in small bowel D₂cc (mean equivalent dose in 2 Gy fractions (EQD₂): 121.6 cGy) compared to the initial treatment (606.0 cGy), while the spacer itself received a mean D₂cc of 690.3 cGy. MRI confirmed complete response at 2 months, with no adverse events observed at that time point. The PGA spacer enabled safe, curative reirradiation in a case that would otherwise be unsuitable for further radiation therapy.

Understand the willingness and preference of patients with knee osteoarthritis for biological treatment, and the current status of knee osteoarthritis treatment. KOA patients with grades 1-4 Kellgren-Ray (K-L) in the knee of our imaging department from November 1, 2022, solstice May 1, 2023, were included in this single-center cross-sectional survey. The questionnaire was designed through the online questionnaire platform, and 502 questionnaires were completed, of which 393 were eligible for this study. (1) Basic information: 66.67% (262/393), female, male 33.33% (131/393), male: 1:2; patients aged 45-69years 89.06% (350/393); 28.50% (112/393); first degree relatives' osteoarthritis 6.87% (27/393); hyperlipidemia 10.94% (43/393); hypertension 30.79% (121/393); diabetes 9.16% (36/393). (2) Disease assessment: the patients had a significant negative relationship between Lysholm score and WOMAC score, with a correlation coefficient of - 0.632, p < 0.01. Using the Kruskal-Wallis test statistic, the Lysholm score showed different K-L grade samples for the WOMAC score (p < 0.01). (3) Classical treatment: 84.99% of the subjects had no attempted basic treatment for osteoarthritis. 94.40% had not tried 4 exercise therapies for osteoarthritis. 96.95% had not attempted physical therapy for osteoarthritis. 98.73% did not try exercise aids for osteoarthritis. 67.94% had not tried TCM treatment for osteoarthritis, accounting for 18.58%, two accounted for 10.69%, three accounted for 2.04%, and four accounted for 0.76%. 77.35% did not try nonsteroidal anti-inflammatory drugs for osteoarthritis, 16.03%, 6.36%, and six 0.25%. 87.02% had not tried non-class NSAIDs analgesic drugs for osteoarthritis, using weak opioid analgesics 10.69% and strong opioid analgesics 2.29%. 95.93% denied previous use of glucocorticoids for osteoarthritis, 16 but not consistently. 85.75% had not tried using slow-acting drugs (SYSADOAs) to relieve OA symptoms, 11.45% and 2.80%, respectively. 99.24% denied taking antidepressant anxiety medication for osteoarthritis. 92.37% denied attempted knee cavity injection (sodium hyaluronate, glucocorticoids), 25 had sodium hyaluronate injection in the joint cavity, 6.36%, and 5 had glucocorticoid injection, 1.27%. (4) Biological therapy situation: 96.44% did not know the biological therapy of the knee cavity for osteoarthritis. 96.69% were not recommended for knee cavity biological treatment, 13 people were recommended, accounting for 3.31%, of which 11 were recommended by doctors, accounting for 84.62% (11/13), and relatives recommended for 15.38% (11/13). In the Likert5 scoring method of joint cavity biological treatment, 10 people in this study were very reluctant, accounting for 2.54%; 37 preferred unwilling, accounting for 9.41%; 264, average, accounting for 67.18%; 40 preferred, accounting for 10.18%; 42, very willing, accounting for 10.69%. The stepwise regression analysis of the factors affecting the willingness to treat joint cavity biotherapy, the previous treatment with sodium hyaluronate or corticosteroid knee cavity injection, WOMAC score will have a significant positive effect on the willingness score of joint cavity biotherapy. In addition, age had a significant negative effect on the willingness to treat the joint cavity. (5) The analysis was performed by MaxDiff: efficacy, course of treatment, side effects, medical expenses, and administration pathways (oral, external use, and intra-articular injection), subject preference for choosing a joint cavity biotherapy. The preferred shares are, respectively. Efficacy > side effect > medical expenses > course of treatment > administration pathways, 69.42% > 15.85% > 6.39% > 4.93% > 3.41%. In this study, KOA subjects, most had not received osteoarthritis-related standard treatment, and the proportion of TCM treatment was relatively high.The lowawareness rate of knee biological therapy, the joint cavity injection treatment, highWOMAC score, and age have an impact on the treatment intention of biologics.Efficacy is the most important factor in patient preference for KOA treatment. Key Points • The low awareness rate of knee biological therapy, the joint cavity injection treatment, high WOMAC score, and age have an impact on the treatment intention of biologics. • Efficacy is the most important factor in patient preference for KOA treatment.

Intra-articular hyaluronan injections represent a widely used and generally safe therapeutic approach for knee osteoarthritis (OA). However, the side effects of this treatment remain insufficiently studied. Acute post-injection reactions, particularly those arising from an improper technique resulting in the deposition of the therapeutic agent into joint tissues, are well-documented. In contrast, chronic hyaluronan-induced inflammatory responses have received scant attention in the scientific literature. The aim of this study is to characterize for the first time the morphological patterns of chronic granulomatous inflammation induced by exogenous hyaluronan (e-HA) in osteoarthritic knees, focusing on three distinct tissue reactions: synovitis, adipositis, and osteomyelitis. Using a three-case series approach and morphological analysis, we identified e-HA penetration pathways; described associated foreign body responses in the synovial, adipose, and bone tissues of the joints; and emphasized the clinical relevance of these underreported adverse effects. These observations highlight an understudied phenomenon-an active conflict between e-HA and joint tissues that recognize it as a foreign body. The prevalence, clinical significance, and prognostic implications of this phenomenon require further investigation.

Before administering hyaluronic acid (HA) fillers, aspiration can be performed as a safety measure to determine whether the needle tip is located within a vascular structure. However, the efficacy and utility of aspiration have been questioned. A real-world evaluation would contribute to understanding how this technique is used globally. The aim of this study was to determine the incidence (as a percentage) of positive pretreatment aspiration in a real-world setting. An observational study with a cross-sectional design was conducted to evaluate the incidence of positive aspiration before facial HA injections. Investigators from 14 aesthetic/dermatologic practices in 9 different countries participated in the study. The active data collection period was 12 weeks. Data of all patients presenting to the participating clinics during the active data-collection phase, and who underwent HA injections to any region of the face, were included. The aspiration technique included slowly pulling back on the plunger of the syringe and holding it back for a minimum of 5 seconds, to allow proper time for flashback. Data from 5106 aspirations performed in 1007 individual patients were collected. In total, 35 cases (0.69%) of positive aspiration were recorded. However, there were significant differences in the incidence reported by investigators (range, 0%-6.72%). The results of this study can be used to assess the utility of pretreatment aspiration as a safety measure before performing HA filler injections, and contribute to the understanding of the effect of various factors on positive preinjection aspiration under clinical conditions.

BackgroundInterdental papilla deficiency is of high concern from the esthetic and functional perspectives. Several invasive approaches have been reported for interdental papilla reconstruction. However, the long-term success of invasive approaches is still controversial, therefore this study aimed to assess the minimally invasive Pouch technique using Leukocyte Platelet Rich Fibrin compared to non-invasive Hyaluronic acid gel injection in the reconstruction of Interdental papilla in esthetic zone.MethodsThe study was designed as a randomized, controlled, double-blinded, and phase (IV) clinical trial. The trial was registered retrospectively with the date (21/7/2023) and registration number (NCT05953896). A total sample size of 20 cases was planned to be recruited. i.e. (10 patients in each group). Patients with deficient interdental papilla class I or II in the esthetic zone were selected, then patients were randomized using computer-generated block randomization into two equal groups: group A (L-PRF) and group B (HA gel). Blinding was performed in selection of patient intervention, while blinding of the intervention wasn’t applicable since both interventions are completely different. The clinical and radiographic parameters were assessed at 3 and 6 months, As well as evaluation of patient satisfaction between the two tested groups.ResultsBoth groups showed significant improvement in all clinical parameters at 3 months and 6 months postoperatively. Assessment of patient satisfaction showed overall improvement in both groups after 6 months, with successful reduction in the mean value of black triangle height of the PRF group: (0.9 ± 0.52), and HA group: (0.6 ± 0.46), with no significant difference (P value: 0.178 ns) between the two groups at 6 months. No significant difference was found in the primary outcomes, and secondary outcomes between the study groups at 6 months.ConclusionsBoth injectable HA and multilayered L-PRF gave successful results that can be comparable to the invasive surgical techniques.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-025-06127-7.

Introduction Health literacy is tied to health outcomes and health disparities, with a significant portion of patients utilizing online patient education materials (OPEM) in medical decision-making. However, orthopedic OPEM are often written above the average eighth-grade reading level of adults in the United States, making them inaccessible to the public. Although there are increasingly more studies examining readability of OPEM, there is a gap in literature on readability of OPEM for knee injections. Also, despite the large Spanish-speaking population, few studies have investigated the readability of Spanish OPEM. Objective Our study aimed to determine whether the English and Spanish OPEM for corticosteroid, platelet-rich plasma (PRP), and hyaluronic knee injections exceeded the average eighth-grade reading level of adults in the United States. Our secondary aim was to determine if there is a significant difference in readability of OPEM for English versus Spanish and for corticosteroid versus PRP versus hyaluronic acid. Methods Two independent reviewers used search terms in Google to identify the top twenty-five English and Spanish OPEM for corticosteroid, PRP, and hyaluronic acid. The name, URL, and classification (i.e. hospital, healthcare organization, professional society) of each web page was recorded. The English pages were analyzed with an online readability calculator, Readable. Well-validated metrics such as Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), Gunning-Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG) were recorded. For Spanish pages, an online calculator, Spanish Readability, was used to determine Fernández-Huerta Index (FHI), FHI grade level, INFLSZ, INFLESZ grade level, Spaulding index, Spaulding grade level, and Crawford grade level. Independent-samples t-test, one-way ANOVA, Fischer’s exact test, and bivariate correlation analysis using Pearson’s coefficient were used to evaluate the readability metrics. Results The overall mean grade level of English OPEM was significantly higher than that of Spanish OPEM for corticosteroid (12.14 ± 2.32 vs 9.49 ± 1.13, p &lt; 0.001). Similarly, the overall mean grade level of search results of English OPEM for PRP was significantly higher than that of its Spanish counterpart (12.24 ± 1.46 vs 9.62 ± 1.10, p &lt; 0.001). Additionally, the overall mean grade level of English for hyaluronic acid was significantly higher than its Spanish counterpart (12.32 ± 1.91 vs 9.49 ± 1.13, p &lt; 0.001). Zero English or Spanish OPEM pertaining to steroid, PRP, or hyaluronic injections of the knee were written below a seventh-grade reading level. When comparing the mean grade levels of the English steroid, PRP, and hyaluronic acid OPEMs to one another, a one-way ANOVA revealed no significant difference (p = 0.947); similarly, a one-way ANOVA revealing no significant difference (p = 0.891) was found when comparing the Spanish steroid, PRP, and hyaluronic acid OPEMs to one another. Conclusions To the best of our knowledge, our study is the first to compare the readability of English versus Spanish OPEM for corticosteroid, PRP, and hyaluronic knee injections. We found that the readability for all injections in both English and Spanish were written significantly higher than the average eighth-grade reading level in the US.

Although intravascular interventional thrombolysis therapy is beneficial for patients suffering from impaired vision caused by hyaluronic acid (HA) embolism, there is no medical evidence-base for the efficacy of this treatment. The aim of this study was to show that intra-arterial thrombolysis therapy (IATT) can effectively improve visual function after impairment caused by facial injection of HA within a certain time window, and to propose a clinically relevant model of retinal ischemia and reperfusion in nonhuman primates. Ophthalmic artery (OA) embolization in rhesus monkeys was induced by injecting HA into the OA, and reperfusion was achieved by IATT with hyaluronidase immediately and at 1, 4, and 24 hours after embolization. Digital subtraction angiography and fundus fluorescein angiography were used to evaluate blood flow before and after retinal reperfusion. Retinal structure and function before and after reperfusion were evaluated by electroretinography, hematoxylin and eosin staining, and transmission electron microscopy. scRNA-seq and bioinformatics analyses were used to detect retinal changes. Angiography confirmed complete ophthalmic arterial embolization after intra-arterial HA injection, and reperfusion after IATT with hyaluronidase. Electroretinography indicated retinal dysfunction following ischemia and recanalization, and it was found that recanalization of the OA at 1, 4, or even 24 hours could improve the visual function of the embolized eye, but some impairment of visual function was nevertheless observed. Histological damage in the retinal cells occurred postembolization. Single-cell sequencing indicated that rhodopsin cytokine expression decreased with longer embolization times. The monkey model presented in this study closely simulated retinal blood flow during OA ischemia and reperfusion in clinical practice and could help elucidate the molecular mechanisms underlying the visual impairment caused by retinal tissue cell ischemia.

Efficacy of computer assisted double-needle arthrocentesis with intra articular injection of sodium hyaluronate versus platelet rich plasma for treatment of TMJ internal derangement (a clinical study)

Short-term clinical outcomes of cross-linked hyaluronic acid filler injection in the treatment of plantar fat-pad atrophy syndrome.