PMC5602722_01
Case 1: (A) Brain magnetic resonance imaging (T2 FS) showing multiple small infarctions and multiple intracranial hemorrhages in the left cerebral hemisphere. (B) The cornea of the left eye 1 day after the injection became edematous. (C) The corneal edema of the left eye is markedly improved 3 weeks after the injection. (D) Fundus photography of the left eye 3 weeks after the injection showing total exudative retinal detachment with retinal atrophy.
TJO-5-36-g001.jpg
PMC5602722_01_TJO-5-36-g001.jpg
F1
Brain magnetic resonance imaging showed multiple small infarctions with intracranial hemorrhages in the left cerebral hemisphere (Fig. 1A). Orbital infarction syndrome developed 1 day after the calcium hydroxylapatite injection (Fig. 1B). The ocular pain and ophthalmoplegia gradually improved (Fig. 1C), but the retina eventually became totally detached (Fig. 1D).
PMC5602722_02
Case 2: (A) Fundus photography of the right eye showing a relatively normal retinal presentation. (B) Ocular fundoscopy over the left eye revealed diffuse drusen-like lesions in the retina and diffuse crystal-like lesions in the level of the choroid. Retinal whitening around the disc is seen in a radial peripapillary capillary distribution. (C) Follow-up fundoscopy of the left eye 5 days later shows disc swelling, extensive small white embolic particulates in the choroidal vessels, and retinal whitening with a flame-shaped intraretinal hemorrhage. (D) The retinal hemorrhage over the left eye resolved; however, the crystal-like linear deposition in the choroidal layer persisted, and the vessels became attenuated. The optic discs were pale.
TJO-5-36-g002.jpg
PMC5602722_02_TJO-5-36-g002.jpg
F2
Fundoscopy of the right eye was relatively normal (Fig. 2A). Retinal whitening was seen around the disc with a radial peripapillary capillary distribution (Fig. 2B). Five days later, a follow-up fundoscopy of the left eye showed disc swelling, extensive small white embolic particulates in the choroidal vessels, and peripapillary retinal whitening with a flame-shaped intraretinal hemorrhage (Fig. 2C). Bilateral optic discs were pale (Fig. 2D).
Case 2: Visual field examination 2 days after the injection reveals altitudinal visual field defects in both eyes, and generalized depression over the left eye.
TJO-5-36-g003.jpg
PMC5602722_02_TJO-5-36-g003.jpg
F3
A visual field examination revealed altitudinal visual field defects in both eyes and generalized depression over the left eye (Fig. 3).