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Unexplained visual acuity after intraocular silicone oil

Session Details

Session Title: Vitreoretinal Surgery II

Session Date/Time: Friday 12/09/2014 | 14:30-16:00

Paper Time: 14:46

Venue: Boulevard C

First Author: : L.Scheerlinck THE NETHERLANDS

Co Author(s): :    P. Schellekens   D. Steijns   A. Liem   R. van Leeuwen     

Abstract Details

Purpose:

to investigate the incidence and characteristics of unexplained visual loss after primary rhegmatogeneous retinal detachment (RRD) without macular involvement treated by vitrectomy with gas or silicone oil (SO) tamponade.

Setting:

University Medical Center Utrecht, The Netherlands, tertiary referral centre.

Methods:

retrospective cohort study of all primary RRD patients without macular involvement treated by vitrectomy with gas or SO tamponade in 2011 and 2012. Patients with visual loss were examined by optical coherence tomography (OCT), perimetry, fluorescein angiography and microperimetry.

Results:

Incidences of unexplained visual loss were 0.7 per cent for patients treated by gas tamponade and 29.7 per cent for patients treated by SO tamponade (P = 0.001). In the SO tamponade group, eleven patients had unexplained visual loss. In seven of them, visual acuity detoriated during SO tamponade and in four patients after SO removal. Median Snellen visual acuity decreased from 0.9 to 0.1, measured before SO tamponade and two months after SO removal. All patients had severely decreased foveal sensitivities on perimetry and microperimetry. OCT showed no structural abnormalities except for statistically significantly lower values for parafoveal retinal thickness and inner plexiform layer thickness in affected eyes compared to fellow eyes (P < 0.001 for both parameters). No other explanation was established based on perimetry, fluorescein angiography and visual evoked potentials.

Conclusions:

Unexplained visual loss is associated with intraocular SO tamponade and can occur during SO tamponade and after SO removal. It seems to be a maculopathy with specific abnormalities on OCT and microperimetry.

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