Título / Title

PURTSCHER-LIKE RETINOPATHY AND PARACENTRAL ACUTE MIDDLE MACULOPATHY CAUSED BY INDUSTRIAL SILICONE EMBOLISM

Introdução / Purpose

To describe a rare occurrence of acute vision loss in a healthy young patient after a cosmetic procedure with industrial silicone for buttock augmentation.

Material e Método / Methods

A previously healthy 26-year-old male-to-female transsexual that presented dyspnea, fever, and hypoxemia 1 day after cosmetic injection of industrial silicone for buttock augmentation. The patient reported decreased vision on right eye 4 days later and decreased vision on left eye 5 days later. Clinical examination revealed cotton wool spots and retinal hemorrhages bilateral. Fluorescein angiography demonstrated macular vascular pruning and an enlarged foveal avascular zone.

Resultados / Results

Fundus exam revealed bilateral retinal precapillary occlusion, demonstrating intraretinal hemorrhages, cotton wool spots, and Purtscher flecks within the posterior pole of both eyes. These findings suggest the diagnose of Purtscher-like retinopathy. Optical coherence tomography demonstrates perifoveal capillary ischemia that corresponds to paracentral acute middle maculopathy.

Discussão e Conclusões / Conclusion

This is a rare case of bilateral acute vision loss attributed to Purtscher-like retinopathy secondary to direct microembolization of the industrial silicone for buttock augmentation.

Palavras Chave

Buttock augmentation; Gluteal augmentation; Purtscher retinopathy; Purtscher-like retinopathy; Industrial Silicone Emboli; silicone embolism; acute vision loss; maculopathy