Retinal Changes before and after Silicone Oil Removal in Eyes with Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography.

Jungwook Lee,Mincheol Seong,Rimkyung Hong,Yongun Shin,Minho Kang,Heeyoon Cho

doi:10.3390/jcm10225436

Abstract

This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.

Highlights

Silicone oil (SO) tamponade is commonly used as a long-term endotamponade to manage various retinal diseases, such as proliferative vitreoretinopathy, complicated tractional or rhegmatogenous retinal detachment with a giant retinal tear, and severe traumatic retinal detachment (RD)
spectral-domain optical coherence tomography (SD-OCT) studies suggested that SO tamponade causes thickness changes in the macular inner retinal layer such as in the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL)
We reviewed the medical records of 30 patients who underwent a 23-gauge pars plana vitrectomy with SO tamponade for the repair of rhegmatogenous retinal detachment (rRD) between October 2016 and November

Summary

Introduction

Silicone oil (SO) tamponade is commonly used as a long-term endotamponade to manage various retinal diseases, such as proliferative vitreoretinopathy, complicated tractional or rhegmatogenous retinal detachment (rRD) with a giant retinal tear, and severe traumatic retinal detachment (RD). There are many reports about anterior and posterior ocular complications associated with SO, including band keratopathy, secondary glaucoma, cataract, increased intraocular pressure, and SO emulsification [1–4]. Another complication of SO tamponade is unexplained visual impairment [2]. SD-OCT studies suggested that SO tamponade causes thickness changes in the macular inner retinal layer such as in the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL). These changes may be related to visual impairment [1,3–5].

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