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Vesna Jurisic Friberg, Goran Bencic, Mia Zoric-Geber, Zoran Vatavuk, Thomas R Friberg; Wide-Field Fluorescein Angiography During and After Silicone Oil Tamponade for Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1026.
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© ARVO (1962-2015); The Authors (2016-present)
Silicone oil is widely used in vitreoretinal surgery to create a long term tamponade. A clinical trial conducted in Zagreb, Croatia (Clinical Trials NCT 01255306) previously showed that of silicone oil caused thickening of the retinal nerve fiber layer. We proposed that this thickening might have been related to inflammatory infiltration, as a small pilot assessment using wide field fluorescein angiography had suggested this. In the present research, we studied a much larger series of eyes and after silicone placement and then after silicone oil removal.
Twenty 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, eyes were imaged through the oil using an ultra-wide field fluorescein angiography platform (Optos P200A, Dunfermline, Scotland). Fluorescein angiography was again performed at 3 and 6 months after oil removal. Images were analyzed and graded by 3 independent ophthalmologists. Patterns of fluorescein leakage were studied in separate regions of the retina.
The average duration of the silicone oil tamponade was 11.5 months (range 4 – 17 months). Ultra-wide field fluorescein angiography was performed after a mean of 7.5 months of in situ silicone oil tamponade (SD 4.3; 95% CI 5.47–9.63). Final fluorescein angiography was performed after a mean of 9.7 months (SD 4.78; 95% CI 7.48 – 11.96). While silicone was in situ, 16 of 20 patient eyes showed fluorescein leakage and was present in the superior retina in 94%. 8 subjects demonstrated macular leakage. The mean area of leakage was 30.8 disc areas (SD 40.72; 95% CI 11.71 – 49.84). On final fluorescein angiography, leakage was noted in 65% of eyes. The most prevalent location for this leakage was the superior retina (85%).
Silicone oil tamponade may precipitate subclinical inflammatory effects, which can persist well after the removal of silicone oil. These results warrant further investigations to assess the cause and prevalence of vascular leakage and possible toxicity.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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