Commentary on: Long-term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection

Lee and Woo have described longitudinal outcomes in 17 eyes of 16 patients after hyaluronic acid (HA) or autologous fat injections for cosmetic procedures.1 They demonstrate that patients with ophthalmic artery occlusion or central retinal artery occlusion suffer the most devastating consequences in terms of irreversible and severe permanent vision loss to the level of no light perception. The rates of autologous fat injections in ophthalmic artery occlusion and central retinal artery occlusion were higher than in patients with branch retinal or posterior ciliary retinal artery occlusion, all of whom received HA injections. This is consistent with prior studies, including a systematic review noting that 47% of cases associated with blindness were after autologous fat injections and 28% of cases were following HA injections, and 1 evaluating cerebral angiography in patients with vision loss after cosmetic filler injections that demonstrated large proximal defects in the ophthalmic artery in autologous...