Unexplained Vision Loss Following Silicone Oil Tamponade
10.21561/jor.2025.10.1.64
- Author:
Woojung CHAE
1
;
Seungwoo LEE
Author Information
1. Department of Ophthalmology, Dongguk University College of Medicine, Gyeongju, Korea
- Publication Type:ORIGINAL ARTICLE
- From:
Journal of Retina
2025;10(1):64-71
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study was performed to evaluate the clinical characteristics, risk factors, and outcomes of unexplained vision loss associated with silicone oil (SO) tamponade in patients undergoing pars plana vitrectomy for rhegmatogenous retinal detachment.
Methods:This retrospective, single-center study included patients who experienced unexplained vision loss during SO tamponade or after SO removal between 2016 and 2024. Unexplained vision loss was defined as a best-corrected visual acuity (BCVA) decline of at least two Snellen lines without identifiable secondary causes. Preoperative and postoperative BCVA, intraocular pressure, and retinal imaging parameters-including central macular thickness and ganglion cell-inner plexiform layer (GCIPL) thickness-were analyzed using sweptsource optical coherence tomography.
Results:Among 153 patients, eight (5.2%) developed unexplained vision loss. The mean age was 57.4 ± 6.6 years, and 75% were male.The mean duration of SO tamponade was 143.9 ± 27.5 days. In macula-on cases, BCVA significantly declined from 0.30 ± 0.25 preoperatively to 0.84 ± 0.82 after SO removal (p = 0.042). GCIPL thickness also significantly decreased from 73.8 ± 7.4 μm preoperatively to 52.8 ± 16.7 μm after SO removal (p < 0.05), indicating retinal damage despite SO removal. In macula-off cases, BCVA remained similar between the SO tamponade period (0.37 ± 0.06) and after SO removal (0.58 ± 0.10, p = 0.157). The GCIPL thickness also did not significantly change from the SO tamponade period (58.6 ± 11.9 μm) to after SO removal (58.3 ± 13.7 μm, p = 1.0), suggesting a different pathological mechanism was at play in these cases compared to that in macula-on cases.
Conclusions:Unexplained vision loss following SO tamponade is linked to progressive GCIPL thinning, indicating neurodegeneration.Prolonged SO tamponade may increase the risk of irreversible visual impairment, underscoring the need for careful patient selection, close monitoring, and timely SO removal. Further research is necessary to understand its mechanisms and develop preventive strategies.
