Hsouna Zgolli*, Ines Malek, Chiraz Abdelhedi, Imen Zghal, Leila Nacef.
Department A, Hedi Rais Institute of Ophthalmology (Tunis, Tunisia)
rhegmatogenous retinal detachment, silicone oil, optical coherence tomography, silicone retinopathy
Purpose. To identify tomographic microstructural macular changes before and after silicone oil removal (SOR) in patients undergoing rhegmatogenous retinal detachment (RRD) surgery, and to correlate these findings to the final visual acuity.
Methods. Sixty eyes that underwent vitrectomy with silicone oil (SO) tamponade were included. Full ophthalmological exa- mination with best-corrected visual acuity (BCVA) evaluation was performed, as well as Spectral-Domain optical coherence tomography (SD-OCT) scan, before SOR, 1 month and 3 months postoperatively. The microstructural changes identified in the OCT images were compared before and after SOR. Tomographic findings were correlated with the final BCVA.
Results. Under SO tamponade, SD-OCT revealed evidence of macular changes: epiretinal membrane (ERM) in 25 eyes (62.5%), cystoid macular oedema (CME) in 10 eyes (25%), internal retinal folds in 15 eyes (37.5%) mostly associated with epire- tinal membrane; and persistence of sub-retinal fluid (SRF) in 3 eyes (7,5%). A longer tamponade with silicone oil (average of 8 months) was significantly correlated with more pronounced changes in tomographic macular microstructure (p<0.001). Af- ter SOR, we found an almost complete resolution of tomographic changes. Visual acuity was significantly improved for eyes with ERM and CME after SOR (p= 0.017). It was associated with a decrease in central retinal thickness. Restoration of pho- toreceptor’s layer and external limiting membrane (ELM) was obtained in 32/40 eyes having, in that case, the best final BVCA.
Conclusion. Silicone oil has a damaging effect on the retinal microstructure. The introduction of the SD-OCT played a role to identify implicated mechanisms, for a better management and prevention. Our work focused on various macular microstructural changes caused by SOT. Its duration was an important factor influencing retinal changes and final visual recovery.