Central scotoma associated with intraocular silicone oil tamponade develops before oil removal.

Abstract

BACKGROUND:

Unexplained sudden visual loss after removal of silicone oil from the eye has recently been described. We report the occurrence and features of unexplained central scotoma developing with silicone oil in situ in the vitreous cavity.

METHODS:

A retrospective case series of five patients (from two centres) who reported a central scotoma commencing during silicone oil tamponade was studied. All patients had vitrectomy for macula-on retinal detachment, with ultra-purified silicone oil tamponade (four out of five had giant retinal tear). Investigations included visual acuity, intraocular pressure, optical coherence tomography, fluorescein angiography, visual fields and electrophysiology.

RESULTS:

All patients reported a central scotoma that appeared during oil tamponade. Visual acuity fell by a mean of 0.93 LogMAR units after onset of the scotoma. After cataract extraction and oil removal, vision remained reduced by a mean of 0.8 units. The mean duration of oil in the eye was 2.7 months when the scotoma was noted by the patient. Investigations were performed after removal of oil. Fluorescein angiography (FFA) was performed in two cases and optical coherence tomography (OCT) in five patients. No abnormality was demonstrated. Electrophysiology was performed in five patients with pattern electroretinography suggestive of macular dysfunction in four patients.

CONCLUSION:

This is the first case series describing central scotoma associated with silicone oil in situ. Electrophysiology indicated macular dysfunction in most cases. We suggest that early removal of oil in cases with good visual potential should be considered to avoid this sight-threatening complication.

• Authors: E N Herbert, M Habib, D Steel, T H Williamson
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 244 Issue 2 Pg. 248-52 (Feb 2006) ISSN: 0721-832X [Print] Germany
• PMID: 16047183 (Publication Type: Journal Article)

Chemical References

• Silicone Oils

Topics

• Adult
• Drainage
• Female
• Fluorescein Angiography
• Humans
• Male
• Middle Aged
• Retina (drug effects)
• Retinal Detachment (therapy)
• Retinal Perforations (therapy)
• Retrospective Studies
• Scotoma (etiology)
• Silicone Oils (adverse effects)
• Tomography, Optical Coherence
• Visual Acuity
• Visual Fields
• Vitrectomy
• Vitreous Body