Clinical Outcome of Cystoid Macular Edema in Silicone Oil–Filled Eyes

Abstract

Purpose: To investigate the clinical outcome of cystoid macular edema (CME) in eyes undergoing silicone oil (SO) tamponade with subsequent SO removal (SOR). Methods: A retrospective case series of adult patients with CME treated with SO tamponade and SOR was conducted between January 2015 and January 2021. Exclusion criteria included eyes with a prior SO tamponade, those that did not undergo SOR, or those with infectious/inflammatory diagnoses. The primary outcomes were the incidence and resolution rates of CME in eyes with SO tamponade that have undergone SOR. The secondary outcomes included changes in best-corrected visual acuity (BCVA) and central field thickness (CFT). Results: Nineteen eyes of 19 patients (58% men) aged 52 years (IQR, 45-66 years) met study inclusion criteria. The median (IQR) follow-up duration post SOR was 22 (8-35) months. Mean CFT decline for the CME-resolved cases was 13.1 µm/mo ( P = .257). CME resolved in only 10 (53%) eyes, 7 (67%) of which occurred after SOR. Median (IQR) BCVA was 20/400 (20/200 to 20/1262) at CME diagnosis and 20/796 (20/252 to hand motion) after SOR, with 0.184 worsening in logMAR BCVA ( P = .340). Medical treatment was not associated with CME resolution compared with observation (50% vs 89%, respectively; P = .069). Eyes with proliferative vitreoretinopathy (PVR) had a higher rate of persistent CME compared with eyes with other diagnoses (78% vs 10%, respectively; P = .005). Conclusions: Nearly half had nonresolution of CME after SO was removed. Visual acuity at last follow-up was unaffected by CME resolution. Preoperative PVR may be a risk factor for unresolved CME.

From the Editor-in-Chief

“…Shaheen et al 2 present the Bascom Palmer Eye Institute experience with cystoid macular edema (CME) in the setting of retained silicone oil and note the difficulty with its treatment and the potential for persistent CME even after silicone oil removal.…”

Macular Edema Following Silicone Oil Tamponade for Retinal Detachment: A Literature Review

“…The authors reported that ME resolved in 10 eyes, seven of which occurred after SO removal. They also highlighted that eyes with PVR had a higher rate of persistent ME [46]. Er et al investigated 65 eyes, which were divided into three groups based on the duration of silicone tamponade: ≤3 months, 3-6 months, and ≥6 months.…”