MRI findings of ocular complications in patients with visual impairment after facial cosmetic injection
Objective To summarize the MRI findings of ocular complications in patients with visual impairment after facial cosmetic injection. Methods A retrospective analysis was performed on the orbital high-resolution MRI of 73 patients who came to the Fourth Medical Center of Chinese PLA General Hospital from December 2015 to May 2023 due to the sharp decline in monocular vision after facial cosmetic injection in other hospitals, including 38 cases of visual impairment in left eye and 35 cases of visual impairment in right eye. Observation contents of MRI included whether there were ischemic optic neuropathy, retinal ischemic injury, extraocular muscle ischemic edema, eyelid ischemic edema, retrobulbar effusion, eyeball atrophy, exophthalmos or not and MRI findings. Results All 73 cases (100％) showed ischemic optic neuropathy on MRI. Focal lesions of intraorbital segment of optic nerve were found in 38 cases, of which 2 cases were multisegmental. In 35 cases, the total intraorbital segment of optic nerve were involved. All 73 cases showed significantly high signal intensity on the high-resolution diffuse Resolve sequence and decreased signal on ADC map, with iso-signal intensity on T1WI, iso-signal or slight hyper-signal intensity on T2WI. Retinal ischemic injury occurred in 52 cases (71.2％), which showed retinal arc-shaped hyper-signal intensity on the high-resolution diffuse Resolve sequence. In 45 cases (61.6％), ischemic edema of extraocular muscles were observed, which were characterized by thickening and swelling of the involved extraocular muscles, and slight hyper-signal intensity on T2WI. Retrobulbar effusion was found in 21 cases (28.8％), which was manifested as patchy slightly hyper-signal intensity in the muscle cone behind the eyeball on the axial T2WI-FS sequence. 33 cases (45.2％) developed upper eyelid ischemic edema, which was characterized by upper eyelid swelling and slightly elevated signal intensity on axial T2WI-FS. Eyeball atrophy and deformation occurred in 7 cases (9.6％). Exophthalmos occurred in 4 cases (5.5％). Conclusion Ocular complications in patients with visual impairment caused by facial cosmetic injection can manifest as ischemic optic neuropathy, retinal ischemic injury, extraocular ischemic edema, upper eyelid ischemic edema, retrobulbar effusion, eyeball atrophy and exophthalmos on MRI.
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