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Goran Bencic, Mia Zoric-Geber, Zoran Vatavuk, Thomas Friberg; Wide Field Fluorescein Angiography in Silicone Oil Filled Eyes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6279.
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Silicone oil is widely used as a tamponade agent in vitreoretinal surgery. A clinical trial conducted in Zagreb, Croatia (Clinical Trials NCT 01255306) assessed the effect of silicone oil on the thickness of peripapillary retinal nerve fiber layer and showed thickening of RNFL. The cause of such thickening might have been related with inflammatory infiltration, documented by several human and animal studies. This finding encouraged us to image eyes containing silicone oil after successful retinal reattachment using a commercially available ultra-wide field fluorescein angiography platform.
Twelve patients with primary rhegmatogenous retinal detachment underwent successful pars plana vitrectomy with silicone oil tamponade (Bausch & Lomb, Oxane 1300, Bausch & Lomb UK ) After retinal reattachment, patients were imaged through the oil using an ultra-wide field fluorescein angiography platform (Optos P200A, Dunfermline, Scotland). After removal of the silicone oil, fluorescein angiography was again performed postoperatively at 3 and 6 months. Images were analyzed and graded by 3 independent ophthalmologists. Patterns of fluorescein leakage were studied in separate regions of the retina: macula, optic disc, superior and inferior retina.
The average duration of the silicone oil tamponade was 11.5 months (range 4 - 17 months). Ultra-wide field fluorescein angiography was performed on average after 9.1 months of silicone oil tamponade ( range 14 days - 17 months). Out of 12 patients, only one did not exhibit any leakage during the silicone oil tamponade. The remaining 11 patients showed following patterns of fluorescein leakage: macula - 4 subjects; optic disc - 4 subjects; superior retina - 10 subjects; inferior retina - 3 subjects. After silicone oil removal, fluorescein angiography showed following patterns of leakage: macula - 7 subjects; optic disc - 3 subjects; superior retina - 10 subjects; inferior retina - 3 subjects. Interestingly, in 3 subjects, we noted the development of macular leakage 3 and 6 months post silicone oil removal, which was not present during the period when the silicone oil was in the eye.
It appears that silicone oil tamponade may precipitate subclinical inflammatory effects, which can persist after the removal of silicone oil. These results warrant further investigations to assess the cause and prevalence of vascular leakage and possible toxicity.
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