Abstract
Purpose :
The overall aim of this project is to describe a new Optical Coherence Tomography (OCT) imaging finding associated with potential silicone oil (SO) maculopathy or macular toxicity in patients with intraocular SO following uncomplicated vitrectomy for retinal detachment (RD) repair.
Methods :
In a retrospective chart review we evaluated the OCT images of patients who carried the diagnosis of SO maculopathy. All patients with the diagnosis of a macula-on RD who underwent uncomplicated vitrectomy with SO seen at the OSU Department of Ophthalmology between 1/1/16 and 11/30/19 were eligible for this study. Patients who carry both the above diagnosis and had clear OCT images were included in the study. Data including past ocular history, pathologic characteristics, treatment characteristics, demographic information, OCT images and fundus photos were collected. OCT and fundus photos were reviewed by experienced retinal specialists at OSU and correlated with the subjects’ documented clinical course.
Results :
Four patients with SO maculopathy were identified and included in the study. Patients ranged from 29 to 75 years of age. 50% of were female, and 50% male. All 4 patients experienced significant unexplained declined in the best corrected visual acuity (8.75 +/- 3.40 lines lost, CI 95%) as a result of potential SO maculopathy. In all 4 patients, OCT images revealed one or more hyper-reflective lines at the center of fovea that extended through all layers of the retina, from the internal limiting membrane to the retinal pigmentated epithelial layer. This OCT finding appeared following SO placement in the eye and this correlated with the onset of the visual acuity loss. Three of the patients who underwent SO removal lost an average of 8.33 lines of vision from their baseline. One patient who declined SO removal, lost a total of 10 lines of vision.
Conclusions :
Unexplained loss of visual acuity following SO placement in the eye for uncomplicated RD repair has been believed to be due to SO macular toxicity. The pathophysiology is unknown but one of the current theories is the potential dissolution of macula lutein and zeaxanthin pigments by the SO. The OCT finding we describe shows a possible communication and extension of SO to the sub-retinal space which supports that theory.
This is a 2020 ARVO Annual Meeting abstract.