ObjectiveTo observe the cilioretinal artery and its relationship with central visual loss in central retinal artery occlusion(CRAO) patients. MethodsA total of 140 CRAO patients (140 eyes) were enrolled in this study. The patients included 83 males and 57 females. The age was ranged from 42 to 75 years old, with an average of (55.70±22.20) years. All the patients were affected unilaterally, including 79 right eyes and 61 left eyes. The disease duration was from 1 to 10 days, with a mean of (4.7±3.9) hours. Central vision and fluorescence fundus angiography were measured for all patients. The central visual loss was divided into 3 types: mild (≥0.1), moderate (finger counting to 0.08) and severe (no light perception to hand movement). The number, length and location of cilioretinal artery were observed. The correlation between cilioretinal artery and central visual loss was analyzed. ResultsThere were 41 eyes (29.3%) with cilioretinal artery, which including 13 eyes (31.7%) with ≥3 cilioretinal arteries, 23 eyes (56.1%) with 2 cilioretinal arteries, 5 eyes (12.2%) with 1 cilioretinal arteries. The cilioretinal artery was within 1 disk diameter (DD) in length and not reached the macular area in 37 eyes (90.2%), was more than 1DD in length and reached the macular foveal area in 4 eyes (9.8%). The cilioretinal artery located in the temporal side of optic disk in 29 eyes (70.7%), and in other quadrant in 12 eyes (29.3%). The distribution of central visual loss degree as follow: mild in 15 eyes (10.7%), moderate in 50 eyes (35.7%), severe in 75 eyes (53.6%). The difference of central visual loss in the eyes with or without cilioretinal arteries was not significant (χ2=0.16, P>0.05). ConclusionsCilioretinal artery exists in 29.3% CRAO eyes. There was no close correlation between cilioretinal artery and central visual loss.
ObjectiveTo observe the clinical characteristics of ophthalmic and cerebral artery occlusion after facial cosmetic injection.MethodsA retrospective case study. Twenty patients (20 eyes) with ophthalmic and cerebral artery occlusion in Department of Ophtalmology, The Fourth Hospital of Xi’an from February 2014 to December 2016 were enrolled in this study. There were 2 males (2 eyes) and 18 females (18 eyes). They aged from 21 to 41 years, with the mean age of 29.8±1.4 years. The disease courses was ranged from 3.5 hours to 21 days, with the mean of 40 hours. Facial cosmetic injections of all patients were performed at out-of-hospital beauty institutions. The visual impairment was associated with eyelid pain 1 to 10 minutes after injection.There were 12 right eyes and 8 left eyes.The injection materials, 18 patients were hyaluronic acid and 2 patients were autologous fat, respectively. At the injection site, 13 patients were sacral, 4 patients were nasal, and 3 patients were frontal. The concentration and dose of the injected filler were not known. All patients underwent vision, slit lamp microscope, fundus color photography, visual field, FFA, OCT, and brain CT, magnetic resonance angiography (MRA) examination.ResultsThe visual acuity was ranged from no light perception to 1.0. Among the 20 eyes, 3 eyes (15%) were obstructed by simple ophthalmic artery; 5 eyes (25%) were obstructed by ophthalmic artery combined with cerebral artery; 7 eyes (35%) were obstructed by simple retinal artery occlusion (RAO) alone, which including central RAO (CRAO, 4 eyes), hemi-lateral artery obstruction (1 eye) and branch RAO (2 eyes); 1 eye (5%) was CRAO with ciliary artery branch obstruction; 1 eye (5%) was branch artery occlusion with ischemic optic neuropathy; 2 eyes (10%) were CRAO with nasal dorsal artery occlusion; 1 eye (5%) was CRAO, posterior ciliary artery obstruction and right middle cerebral artery occlusion. Among 20 patients, 4 patients (20%) had eye movement disorder and eyelid skin bun; 2 patients (10%) had facial pain and nasal skin ischemic necrosis. MRA revealed 6 patients (30%) of new intracranial ischemic lesions. Among them, 5 patients of hyaluronic acid injection showed asymptomatic small blood vessel embolization; 1 patient of autologous fat injection showed ophthalmary artery occlusion, cerebral artery occlusion, ipsilateral eye blindness, eye movement disorder and contralateral limb hemiplegia.ConclusionFacial cosmetic injection can cause severe iatrogenic complications such as RAO, ciliary artery occlusion, ischemic optic neuropathy, ophthalmic artery occlusion, and cerebral artery occlusion.