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Article ; Online: The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection.

Graue, Gerardo / Ochoa Araujo, Dora Aline / Plata Palazuelos, Cristina / Núñez Medrano, Juan Ángel / López San Juan, Fernando José / Sánchez Pereda, Daniela / Capiz Correa, Daniel Raúl / de Velasco, Leopoldo

Journal of cosmetic dermatology

2020  Volume 19, Issue 11, Page(s) 2859–2866

Abstract: Objective: To propose an algorithm of treatment for sudden visual loss following filler injections and perform an English-written literature search for assignment of evidence level and grade recommendation.: Methods: Algorithm of treatment includes ... ...

Abstract Objective: To propose an algorithm of treatment for sudden visual loss following filler injections and perform an English-written literature search for assignment of evidence level and grade recommendation.
Methods: Algorithm of treatment includes ocular physical Maneuvers, hyAluronidase administration, intravenous STEroids, intraocular pressure Reduction, and Supplemental Oxygen (M.A.STE .R.S) based on previous acute management reports. Special consideration for algorithm buildup was made for ophthalmic diseases that share physiopathological features such as central retinal artery occlusion, systemic vasculitis affecting vision, and acute glaucoma. Finally, a systematic cross-review of the reported cases with visual loss was done to identify the level of evidence and grant a recommendation grade.
Results: A search through PubMed and Medscape databases for English-written scientific papers using the terms facial filler, retinal artery occlusion, management, treatment, complications, and adverse events quoted a total of 46 papers (190 cases) which were then analyzed. A high variability on management for treatment of sudden visual loss after facial filler injections was observed. This was attributed partially to the great diversity of medical specialists performing cosmetic facial procedures such as dermatologists, plastic surgeons, esthetic doctors and ophthalmologists, and the lack of high evidence level studies.
Conclusions: The proposed algorithm provides an initial guideline based on prior literature reports and physiopathology involving facial filler injection complications. Analysis identified 22 successfully treated cases with vision recovery (11.57%). Ocular physical maneuvers had the best evidence-based level and grade recommendation (A) for the management of acute vision loss secondary to facial filler injections.
MeSH term(s) Algorithms ; Blindness/chemically induced ; Blindness/therapy ; Cosmetic Techniques/adverse effects ; Dermal Fillers/adverse effects ; Face ; Humans ; Retinal Artery Occlusion/chemically induced ; Retinal Artery Occlusion/therapy
Chemical Substances Dermal Fillers
Language English
Publishing date 2020-04-08
Publishing country England
Document type Journal Article
ZDB-ID 2280551-5
ISSN 1473-2165 ; 1473-2130
ISSN (online) 1473-2165
ISSN 1473-2130
DOI 10.1111/jocd.13393
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