Unexplained visual loss in association with silicone oil endotampoande in patients with macula-on rhegmatogenous retinal detachments

摘要

Purpose : To report incidence and outcomes of unexplained visual loss in patients undergoing pars plana vitrectomy (ppV) with silicon oil (SO) endotamponade for macula sparing primary rhegmatogenous retinal detachment (RRD) repair. Methods : Retrospective analysis of all eyes that underwent ppV from 2012 to 2014. Data reviewed were age, gender, preoperative macular status, ophthalmological history and postoperative course. Only primary macula-on RRDs were included. Factors potentially affecting outcome were refractive error, presence of giant retinal tear, presence and grade of pre-operative proliferative vitreoretinopathy (PVR) , lens status, duration and type of SO endotamponade and perioperative complications. An unexplained vision loss was defined as a loss of 2 Snellen Lines without evident explanation for visual loss. Results : A total of 1218 eyes underwent ppV. In 248 (20.4%) cases a silicone oil filling was needed due to giant retinal tears, inferior tear location and significant PVR. Overall 59 primary macula-on RRD were treated with SO. After exclusion of 6 patients, which were lost to follow up, and 9 patients with an explained visual loss, 45 patients remained for final analysis. 9 out of these had an unexplained visual loss (20%). Mean visual acuity dropped from 0.1 logMAR preoperatively to 0.8logMAR (p0.001). In eyes without a visual loss, vision improved slightly from 0.2 to 0.18 logMAR. Mean duration of silicone oil filling in the group with vision loss was 161.0 ?±38.8 days compared to 104.6 days ?± 43.6 and was identified as a risk factor for developing visual loss (p0.001). Conclusions : Unexplained visual loss in association with silicone oil endotamponade is a serious and severe complication in the surgical treatment of macular sparing RRD. The incidence of an unexplained visual loss in our population is comparable to previous studies, which reported incidence rates of 30% and seems to be associated to SO endotamponade duration. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.