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INCIDENCE, RISK FACTORS, AND CLINICAL CHARACTERISTICS OF UNEXPLAINED VISUAL LOSS AFTER INTRAOCULAR SILICONE OIL FOR MACULA-ON RETINAL DETACHMENT

Scheerlinck, Laura M. MD; Schellekens, Peter A. MD; Liem, Albert T. MD, PhD; Steijns, Daan MD; van Leeuwen, Redmer MD, PhD

doi: 10.1097/IAE.0000000000000711
Original Study
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Purpose: To investigate the incidence, risk factors, and clinical characteristics of unexplained visual loss after macula-on rhegmatogenous retinal detachment (RRD).

Methods: Retrospective cohort of patients with primary macula-on rhegmatogenous retinal detachment treated by vitrectomy with gas or silicone oil (SO) tamponade in 2011 and 2012. Outcome was unexplained visual loss (>2 Snellen lines) 2 months after the last vitrectomy.

Results: Incidence of unexplained visual loss was 0.7% (1/151) in patients treated by gas and 29.7% (11/37) in patients treated by SO (P = 0.001). Visual loss occurred both during SO tamponade and after removal. Cases underwent optical coherence tomography, perimetry, microperimetry, fluorescein angiography, and visual evoked potentials. Patients with unexplained visual loss after SO tamponade showed a small scotoma within the central 2° on microperimetry. Duration of SO tamponade was the only statistically significant factor related to the incidence of unexplained visual loss (P = 0.001).

Conclusion: Incidence of SO-related visual loss was 30% with duration of tamponade as the only risk factor. This study is the first to apply microperimetry in these patients, which showed a distinct pattern of a small central scotoma. Therefore, microperimetry can be of great value in the diagnostic workup of patients with unexplained visual loss after vitrectomy.

In this retrospective cohort study, the incidence of silicone oil–related visual loss was 30%, with duration of tamponade as the only risk factor. Microperimetry showed a distinct pattern of a small and deep central scotoma. Optical coherence tomography demonstrated significant thinning of the ganglion cell and inner plexiform layer. Microperimetry can be of great value in the diagnostic workup of unexplained visual loss after silicone oil tamponade.

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.

Reprint requests: Laura M. Scheerlinck, MD, Department of Ophthalmology, University Medical Center Utrecht, E03-136, Heidelberglaan 100, P.O. Box 85500, 3508 GA Utrecht, The Netherlands; e-mail: l.m.e.scheerlinck@umcutrecht.nl

Supported by Dr. FP Fischer Stichting, Amersfoort; Foundation for Dutch Ophthalmologic Research (SNOO), Utrecht; Algemene Nederlands Vereniging ter Voorkoming van Blindheid, Doorn; Stichting Winckel-Sweep, Utrecht.

None of the authors have any conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.