Abstract
Purpose
Presumed silicone oil-related retinal toxicity causes central vision loss with a reported incidence of 1–33% in the first month after oil removal and 10% in the first six months of having silicone oil in-situ. This report examines local rates in a tertiary hospital that manages many geographically distanced patients. A miniature literature review, audit and case series are presented.
Methods
A retrospective audit of all patients who underwent a 'removal of silicone oil' surgery at the Royal Brisbane and Women's Hospital between 2016 and 2021. Inclusion criteria were that the oil was inserted for primary or recurrent rhegmatogenous retinal detachment. Visual acuity was analysed at presentation, at 1 and 3 months of oil in-situ, preoperatively to removal of oil and up to 6 months after oil removal. Ocular coherence tomographic parameters were examined at each time interval, including nerve fibre layer (NFL) and ganglion cell layer and inner plexiform layer (GCL + IPL) thicknesses in the 3 mm parafoveal zone, presence of inner retinal microcystic changes or intraretinal silicone oil globules. Patients were identified who had unexplained vision loss of two or more Snellen lines. Further analysis and case review were performed.
Results and conclusions
Between January 2016 and May 2021, 101 patients met the inclusion criteria. Three patients had significant and unexplained visual loss. They are presented in this paper. Presumed silicone oil toxicity is an increasingly recognised and potentially devastating phenomenon that vitreo-retinal surgeons should be wary of. Patients should be specifically consented for it and hospitals should perform local auditing to determine their own rates and inform this discussion.
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All work on this manuscript was undertaken by Dr. Rajan Patheja. This included data collection and analysis as well as writing and preparation of the manuscript.
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This retrospective chart review, audit activity and case series presentation were approved and deemed exempt from full ethical review by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (HREC).
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All patients reported on in this case series were selected through retrospective chart review. Each patient has been completely deidentified and has given consent for me to report and publish on the details of their cases as well as the use the relevant OCT, Optos and visual field images.
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Patheja, R.S. A reminder about silicone oil toxicity: three cases over five years in a tertiary hospital. Int Ophthalmol 43, 1477–1486 (2023). https://doi.org/10.1007/s10792-022-02544-7
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DOI: https://doi.org/10.1007/s10792-022-02544-7