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This is a case of Purtscher-like retinopathy associated with paracentral acute middle maculopathy caused by industrial silicone embolism after an illicit cosmetic procedure for buttock augmentation. Color fundus photography and optical coherence tomography were able to determine the characteristics features of Purtscher-like retinopathy and paracentral acute middle maculopathy. 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. [ABSTRACT FROM AUTHOR]

Background To describe the clinical presentation and characteristic imaging features of deep retinal haemorrhages primarily located in the Henle fibre layer (HFL) of the macula. The spectrum of aetiologies and a comprehensive theory of pathogenesis are presented. Methods This is a retrospective, multicentre case series evaluating eyes with retinal haemorrhage in HFL. Clinical features, underlying aetiology, systemic and ocular risk factors, visual acuity, and multimodal imaging including fundus photography and cross-sectional and en face optical coherence tomography (OCT) are presented. Results Retinal haemorrhages localised to HFL in 33 eyes from 23 patients were secondary to acute blunt trauma to the head (n=2), eye (n=1) and trunk (n=1), ruptured intracranial aneurysm (Terson's syndrome, n=3), general anaesthesia (n=1), epidural anaesthesia (n=1), hypertension with anaemia (n=1), decompression retinopathy (n=1), postvitrectomy with intraocular gas (n=1), retinal vein occlusion (n=7), myopic degeneration (n=2), macular telangiectasia type 2 (n=1), and polypoidal choroidal vasculopathy (n=1). Defining clinical features included deep retinal haemorrhage with feathery margin and petaloid pattern radiating from the fovea. OCT demonstrated characteristic hyper-reflectivity from the haemorrhage delineated by obliquely oriented fibres in the Henle layer. Spontaneous resolution of HFL haemorrhage occurred after 3 months in 15 patients with follow-up. Conclusion The characteristic petaloid-shaped, deep intraretinal haemorrhage with a feathery margin localised to HFL is associated with various disorders. The terminology 'Henle fiber layer hemorrhage (HH)' is proposed to describe the clinical and OCT findings, which may result from abnormal retinal venous pressure from systemic or local retinovascular disorders affecting the deep capillary plexus or from choroidal vascular abnormalities. [ABSTRACT FROM AUTHOR]

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