Ophthalmic artery occlusion after dermal fillers injectionA young female patient developed left-sided headache, periorbital pain, and acute loss of vision within a few minutes after receiving left-sided nasal hyaluronic acid dermal fillers. Visual acuity of her left eye was no light perception, with a grade 4 relative afferent pupillary defect. Posterior segment examination revealed marked edema of the posterior pole with absence of cherry-red spot, suggestive of an iatrogenic ophthalmic artery occlusion. Multiple emboli (A, arrows) were seen within the central retina artery and branching arterioles.
Bilateral curvilinear chorioretinal streaksA 46-year-old Caucasian woman presented with distorted vision in both eyes. Visual acuity was 20/25 OD and 20/50 OS. Fundus examination showed bilateral concentric chorioretinal streaks (Fig. A, B), which were hyperfluorescent on fluorescein angiography (Fig. C, D). The scars had formed in a curvilinear pattern called Schlaegel lines associated with multifocal choroiditis and panuveitis (MCP). She developed choroidal neovascularization (CNV) and was treated with photodynamic therapy. Her visual distortions resolved and vision improved to 20/20 OD and 20/25 OS.
Scleral needling techniqueScleral needling technique is a novel, safe, and simple alternative to suturing for effectively securing leaking sclerotomies in microincision vitrectomy surgery. After air–fluid exchange and trocar cannula removal (A), air bubbles are visualized at the site of wound leakage by dripping balanced salt solution over the open sclerotomy (B). A closed 30-gauge needle syringe is perpendicularly inserted full thickness through the sclera adjacent to the scleral opening and removed immediately (C). The wound is then pressed with a blunt cannula.