Purtscher-like retinopathy and paracentral acute middle maculopathy caused by industrial silicone embolism.

PURPOSE:This article describes a rare occurrence of acute vision loss in a healthy young patient after a cosmetic procedure. METHODS:Findings on clinical examination, color fundus photography, and swept-source optical coherence tomography angiography. RESULTS:A previously healthy 26-year-old male-to-female transsexual presented with dyspnea, fever, and hypoxemia 1 day after cosmetic injection of industrial silicone for buttock augmentation. The patient reported decreased vision on the right eye 4 days later and decreased vision on the left eye 5 days later. Fundus examination revealed bilateral retinal precapillary occlusion, demonstrating intraretinal hemorrhages, cotton wool spots, and Purtscher flecks within the posterior pole of both eyes. Optical coherence tomography angiography revealed capillary ischemia and an enlarged foveal avascular zone. CONCLUSION:Swept-source optical coherence tomography is a valuable tool for evaluation of Purtscher-like retinopathy and paracentral acute middle maculopathy.