Retinal toxicity by intravitreal liquid perfluorocarbon

Abstract

PurposeTo report retinal changes in a population of patients who had undergone vitreoretinal surgery using liquid perfluorocarbon (LPFC).MethodsSingle centre, retrospective study. The clinical records and images of patients who had undergone vitreoretinal surgery during the 36 months prior to the sanitary alert issued by the Spanish Health Authorities on ALA OCTA LPFC were revised.ResultsFour different brands of LPFC had been used during the 36 months period, including ALA OCTA. 128 patients were identified who had undergone vitreoretinal surgery with LPFC of whom 44 had been treated with ALA OCTA. None of the eyes fulfilled the diagnostic criteria of the sanitary alert issued by the Spanish Health Authorities (no light perception + retinal necrosis + optic disk atrophy). No sign of retinal necrosis or severe ocular inflammation was identified in any of the eyes treated with any of the brands during postoperative follow‐up or at the final visit. Optic disk atrophy was identified in 6 eyes, and limited venous sheathing was observed in one eye treated with ALA OCTA vs. no cases in eyes treated with other brands. SDOCT revealed retinal ganglion cell layer vacuolization in eight eyes and inner nuclear layer vacuolization in five eyes treated with ALA OCTA.ConclusionsA range of retinal lesions were identified in patients operated on with the aid of LPFC. These changes and lower final visual acuities were more frequently observed but were not exclusive among eyes treated by ALAOCTA LPFC. LPFC toxicity must be carefully evaluated in a case‐by‐case basis in order to elucidate the role of LPFC and other factors involved