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Esmaili, Daniel D., MD

Retinal Cases and Brief Reports: December 2017 - Volume 11 - Issue - p S28–S30
doi: 10.1097/ICB.0000000000000393
Case Report

Purpose: To describe a patient with ophthalmic artery occlusion after sodium tetradecyl sulfate foam injection in the forehead.

Methods: In this case report, a description of the clinical examination and imaging findings, including fundus photography, spectral-domain optical coherence tomography, and fluorescein angiography are reported.

Results: A 33-year-old white woman presented with severe painless vision loss in the left eye after cosmetic treatment of a forehead vein with sodium tetradecyl sulfate foam. Her visual acuity in the left eye was hand motions, and her fundus revealed diffuse retinal whitening in the macula with the absence of a cherry red spot and disruption of the arteriolar blood supply. Spectral-domain optical coherence tomography revealed intense hyperreflectivity of the inner and outer retina with loss of the foveal contour, and fluorescein angiography revealed delayed filling of the choroidal vasculature and cilioretinal artery with incomplete filling of the retinal arterioles in the late frames consistent with ophthalmic artery occlusion.

Conclusion: This case represents a devastating ocular complication after the inadvertent injection of sodium tetradecyl sulfate into a forehead artery, resulting in occlusion of the ophthalmic artery and severe vision loss.

Sodium tetradecyl sulfate is a sclerosing agent used in the treatment of varicose veins. This case illustrates a devastating ophthalmic complication after inadvertent injection of Sodium tetradecyl sulfate foam into a forehead artery.

Retina Vitreous Associates Medical Group, Los Angeles, California.

Reprint requests: Daniel D. Esmaili, MD, Retina Vitreous Associates Medical Group, 1127 Wilshire Boulevard, Suite 1620, Los Angeles, CA 90017; e-mail:

Presented at the proceedings of the Pacific Retina Study Club, Los Angeles, CA, March 18, 2016.

None of the authors have any financial/conflicting interests to disclose.

© 2017 by Ophthalmic Communications Society, Inc.