Sudden Visual Loss After Removal of Silicone Oil

Abstract

We describe a new phenomenon of unexpected visual loss after oil removal in patients with good visual potential. The pathogenesis remains obscure.

Electrolyte composition of retro‐oil fluid and silicone oil‐related visual loss

“…Serum Ocular fluid-to-serum ratio SO patients (n = 16) Controls (n = 27) SO patients (n = 16) Controls (n = 27) SO patients (n = 16) Controls (n = 27) retinal toxicity is thought to be fundamental to this visual loss (Winter et al 2000;Newsom et al 2004;Cazabon et al 2005;Herbert et al 2005;Williams et al 2008;Michel et al 2009;Scheerlinck et al 2015). This study investigated the vitreous concentration of K + during SO endotamponade and its potential association with the development of SORVL.…”

“…Although considered to be safe, well tolerated, and not affecting retinal physiology, up to a third of patients treated by SO tamponade for retinal detachments without macular involvement may suffer from SO-related visual loss (SORVL) (Newsom et al 2004;Cazabon et al 2005;Herbert et al 2005;Williams et al 2008;Michel et al 2009;Christensen & la Cour 2012;Scheerlinck et al 2015). This irreversible, profound and unexplained visual loss can occur during SO tamponade or immediate after SO removal and cannot be explained by complications such as cystoid macular oedema, hyper-or hypotony, or epiretinal membranes (Newsom et al 2004;Cazabon et al 2005;Herbert et al 2005;Williams et al 2008;Michel et al 2009;Christensen & la Cour 2012;Scheerlinck et al 2015). Evaluation by visual field tests or microperimetry typically reveals a small deep central scotoma and a severely decreased central macular function can be detected by multifocal electroretinography (Newsom et al 2004;Herbert et al 2005;Scheerlinck et al 2015).…”

“…This irreversible, profound and unexplained visual loss can occur during SO tamponade or immediate after SO removal and cannot be explained by complications such as cystoid macular oedema, hyper-or hypotony, or epiretinal membranes (Newsom et al 2004;Cazabon et al 2005;Herbert et al 2005;Williams et al 2008;Michel et al 2009;Christensen & la Cour 2012;Scheerlinck et al 2015). Evaluation by visual field tests or microperimetry typically reveals a small deep central scotoma and a severely decreased central macular function can be detected by multifocal electroretinography (Newsom et al 2004;Herbert et al 2005;Scheerlinck et al 2015).…”

“…Retinal electrolyte homeostasis is normally regulated by M€ uller cells, with the vitreous fluid serving as an infinite buffer (Newman 1987). However, electrolytes hardly dissolve in SO which could lead to accumulation in the limited retro-oil fluid volume and consequently in the retina, leading to retinal toxicity and subsequent visual loss (Winter et al 2000;Newsom et al 2004;Williams et al 2008).…”

The incidence of unexplained visual loss following removal of silicone oil

“…11 Unexplained vision loss immediately after ROSO was first described in 2004. 12 Subsequently, further similar series have documented this phenomenon. [13][14][15][16][17][18][19] The etiology and prevalence of this complication is still unclear and this makes counseling patients challenging.…”