Blind-Sided by Cosmetic Vein Sclerotherapy: A Case of Ophthalmic Arterial Occlusion

Abstract

Widely regarded as safe, and approved by the U.S. Food and Drug Administration, the only published ocular side effects of foam sclerotherapy are transient visual disturbances or temporary scotomas. This case demonstrates irreversible loss of vision as a previously unreported complication. While undoubtedly rare, we believe physicians and surgeons using sclerosant in the orbital adnexa, face, nose, and sinuses should be aware of this sight-threatening complication of injection and counsel potential patients accordingly.

Ocular infarction following ethanol sclerotherapy of an arteriovenous malformation

“…OI has previously been reported in the treatment of orbital and temporal lobe AVMs with polyvinyl alcohol, and in the treatment of prominent facial veins with sodium tetradecyl sulphate, 9, 10, 11. However, OI due to ethanol sclerotherapy has not been reported before, this case highlights the disease with multimodal imagining including fundus photos, OCT, and FA.…”

Treatment of facial hypertrophic capillary malformations with tumescent‐assisted sclerotherapy

“…Facial CMs commonly involve the V1 and V2 dermatomes and periorbital involvement is common. Though rare, there are multiple reports of orbital infarction syndrome, cavernous sinus thrombosis and ophthalmic artery occlusion leading to monocular blindness from STS sclerotherapy of periorbital veins or VMs 18,19 …”

“…Though rare, there are multiple reports of orbital infarction syndrome, cavernous sinus thrombosis and ophthalmic artery occlusion leading to monocular blindness from STS sclerotherapy of periorbital veins or VMs. 18,19 Historically, alcohol embolisation has been used for the treatment of facial vascular malformations with higher rates of complications. 20 We avoided the use of alcohol given its complication profile and potential for facial nerve damage.…”

Sclerotherapy in Aesthetic Medicine: Myths and Realities

“…The literature strongly suggests that sclerotherapy should be avoided on the face. Arunakirinathan and colleagues 9 report a case of irreversible unilateral vision loss due to ophthalmic arterial occlusion after STS sclerotherapy treatment for a prominent facial vein on the forehead. Skin necrosis has also reported after polidocanol 0.5% sclerotherapy was performed for enlarged veins in the left lower eyelid and forehead area.…”