Blindness at the Cost of Beauty: Post Liposuction Fat Embolism Presenting as Painless Bilateral Vision Loss
Format
Poster
Start Date
6-11-2020 12:15 PM
End Date
6-11-2020 12:30 PM
Abstract
Fat embolism syndrome (FES) is a rare but well known complication of large volume liposuction and abdominoplasty, most classically presenting with a triad of neurological, pulmonary, and cutaneous symptoms, but with numerous alternate presentations noted in the literature. Vision loss secondary to retinal arterial involvement is a known component of FES, but is typically noted as a secondary finding rather than the primary presenting complaint. We report the first documented case of post-liposuction FES to present as bilateral vision loss. A 57-year-old female with a history of hypertension presented with painless progressive vision loss bilaterally, left eye greater than right, for 4 days as well as dizziness and confusion. She had undergone an abdominoplasty and large volume liposuction 6 days prior, with onset of vision changes post operative day 1. Eye exam without corrective lenses revealed left eye having minimal light perception and right eye 20/40. Fundoscopy showed focal partial retinal pallor, and optic disc edema. After dilated exam by Ophthalmology patient diagnosed with bilateral ischemic optic neuropathy. Labs notable for anemia, elevated WBC, AKI, elevated CRP. Saline contrast TEE that demonstrated no intracardiac shunt. MRI Brain showed multiple foci of diffusion restriction in bilateral globus pallidi with findings concerning for embolic infarcts. By hospital day 8, the anemia and electrolyte abnormalities resolved but her vision had not improved. Patient was discharged to outpatient ophthalmology follow up.
Blindness at the Cost of Beauty: Post Liposuction Fat Embolism Presenting as Painless Bilateral Vision Loss
Fat embolism syndrome (FES) is a rare but well known complication of large volume liposuction and abdominoplasty, most classically presenting with a triad of neurological, pulmonary, and cutaneous symptoms, but with numerous alternate presentations noted in the literature. Vision loss secondary to retinal arterial involvement is a known component of FES, but is typically noted as a secondary finding rather than the primary presenting complaint. We report the first documented case of post-liposuction FES to present as bilateral vision loss. A 57-year-old female with a history of hypertension presented with painless progressive vision loss bilaterally, left eye greater than right, for 4 days as well as dizziness and confusion. She had undergone an abdominoplasty and large volume liposuction 6 days prior, with onset of vision changes post operative day 1. Eye exam without corrective lenses revealed left eye having minimal light perception and right eye 20/40. Fundoscopy showed focal partial retinal pallor, and optic disc edema. After dilated exam by Ophthalmology patient diagnosed with bilateral ischemic optic neuropathy. Labs notable for anemia, elevated WBC, AKI, elevated CRP. Saline contrast TEE that demonstrated no intracardiac shunt. MRI Brain showed multiple foci of diffusion restriction in bilateral globus pallidi with findings concerning for embolic infarcts. By hospital day 8, the anemia and electrolyte abnormalities resolved but her vision had not improved. Patient was discharged to outpatient ophthalmology follow up.