Purpose: We assessed the extent of silicone oil (SO) emulsification using ultra-wide-field fundus photography (wFP) and the reflective ratios of swept-source optical coherence tomography (SS-OCT). Methods: We retrospectively enrolled 51 eyes of 51 patients who underwent intravitreal SO tamponade with vitrectomy. Two weeks after SO tamponade and immediately before SO removal, ultra-wide-field fundus photography and SS-OCT were performed. Based on the numbers of emulsified droplets in the ultra-wide-field fundus photographs, SO emulsification was qualitatively graded from 0 to 4. Reflective ratios were calculated by dividing the OCT reflectivity of the optic cup by the OCT reflectivity of SO near the retinal surface. We analyzed the changes in the SO emulsification grade and the reflective ratio over time (RR2/RR1). Results: The SO emulsification grade revealed by ultra-wide-field fundus photography was 2.12 ± 1.29, and the mean SS-OCT RR2/RR1 value was 1.14 ± 0.22. A longer duration of SO tamponade was associated with a higher emulsification grade on ultra-wide-field fundus photography and an increase in the RR2/RR1 value (both p < 0.01). We found a significant correlation between the SO emulsification grade on ultra-wide-field fundus photography and the SS-OCT RR2/RR1 (p = 0.028). Conclusions Ultra-wide-field fundus photography and SS-OCT can be used to determine objectively the extent of SO emulsification; this may indicate the appropriate SO removal time any complication.

PURPOSE: In the present study, a case of acute retinal necrosis with acute renal injury due to high-dose intravenous antiviral injection which was treated by intravitreal ganciclovir injection is reported. CASE SUMMARY: A 46-year-old female visited our clinic complaining of red eye and decreased vision in the right eye. At the first visit, her corrected visual acuity was finger count in the right eye, and 20/20 in the left eye. Fundus examination of the right eye revealed multiple peripheral arterial occlusion, papilledema, and whitish necrotic infiltration at the periphery. Clinically diagnosed as acute retinal necrosis, the patient was started on intravenous acyclovir. Two days after injection, her serum creatinine level increased, therefore, intravenous acyclovir was discontinued and she was started on intravitreal ganciclovir. Five days after the intravenous injection was discontinued, the serum creatinine level returned to normal range. Four months after the first visit, visual acuity was 20/100 and no recurrence was observed. CONCLUSIONS: Intravitreal ganciclovir injection can be an effective alternative in patients with acute retinal necrosis and poor kidney function.
Acute Kidney Injury* ; Acyclovir ; Creatinine ; Female ; Fingers ; Ganciclovir ; Humans ; Injections, Intravenous ; Kidney ; Middle Aged ; Papilledema ; Recurrence ; Reference Values ; Retinal Necrosis Syndrome, Acute* ; Visual Acuity