To compare the clinical findings and high-resolution optical coherence tomography (OCT) features of two cases of intraretinal silicone oil (SO) migration in the fovea following repair of fovea sparing rhegmatogenous retinal detachment. In case 1, a 53-year-old female with 20/20 visual acuity had a fovea sparing retinal detachment with grade C proliferative vitreoretinopathy repaired with vitrectomy, scleral buckle, and 1000 centistoke SO tamponade for 5 months. After SO removal, visual acuity was 20/400. In case 2, a 66-year-old-male with 20/25 visual acuity presented with a recurrent fovea sparing retinal detachment repaired with vitrectomy, scleral buckle, and 5000 centistokes SO tamponade for 3 months. After SO removal, visual acuity remained 20/25. Intraretinal SO was detected in the fovea on OCT about 4 months after surgery for case 1, and 1 month after surgery for case 2. Intraretinal SO droplets were characterized by focal hyper-reflective light reflexes at the apex and base of SO droplet and increased hyperreflectivity projecting posteriorly. Prototype high resolution (HR) OCT parafoveal layer thickness maps demonstrated ganglion cell layer (GCL) thinning in both cases compared with the contralateral unaffected eye; however, the thinning was more severe in case 1 consistent with worse visual acuity. Over the course of one year HR OCT demonstrated no evidence of adverse reaction to SO and minimal change in SO size and location in both cases. Intraretinal migration of SO into the fovea, after repair of macula sparing retinal detachment, remained stable without evidence of adverse reaction after 1 year of follow-up. Using HR OCT, severe parafoveal GCL thinning, compared to fellow healthy eye, was associated with central vision loss while moderate parafoveal GCL thinning was associated with maintained central vision. Further study is needed to determine if parafoveal GCL thickness measurements can help guide timely SO removal.
Cheng et al. (Wed,) studied this question.