Comparison of fundus changes following silicone oil and sterilized air tamponade for macular-on retinal detachment patients

Abstract

Background To investigate different tamponade effects of intravitreal silicone oil (SO) and sterilized air on macular vasculature and structure after successful retinal repair for macular-on rhegmatogenous retinal detachment (RRD) patients. Method 21 eyes (21 patients) with macular-on RRD underwent single pars plana vitrectomy following intravitreal SO or sterilized air (Gas) tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate retinal layer thickness and flow density (FD) changes throughout the observation period of 12 weeks. Retinal layers were segmented into 7 sets: NFL, GCL + IPL, INL, OPL, ONL + IS, OS+RPE and BRM. Macular perfusion system was segmented into superficial and deep capillary plexus flow density (SCPFD, DCPFD), and choriocapillaries plexus flow density (CCPFD). Result Compared to Gas tamponade, SO tamponade led to more decrease in both superficial and deep retinal blood flow during observation. NFL thickness was found to decrease in both Gas tamponade and SO tamponade eyes. SO tamponade resulted in more pronounced decrease which led to significant intergroup difference. Opposite changing trends were found in GCL + IPL and ONL + IS thicknesses due to different means of tamponade. SO tamponade caused thicknesses of these two segmented layers to decrease, which led to significant intergroup differences. SO tamponade also led to more decrease in INL, OPL thicknesses. No significant intergroup difference of choroidal thickness was observed. Conclusion Compared to gas, silicone oil could have more negative tamponade effects on both fundus vasculature and structure.

The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis

“…Based on the inclusion and exclusion criteria, 16 articles were found to be eligible: five studies had arms only evaluating the CMT [ 24 – 29 ], three studies only evaluating the inner retinal layer thickness [ 7 , 8 , 28 ]. five studies evaluating both CMT and retinal layer segmentation thickness [ 14 , 15 , 17 , 30 , 31 ], and three studies only evaluating the SFCT [ 16 , 32 , 33 ].In the search of Persian databases, no relevant studies were found. Figure 1 presents the flow chart of the selection process used to identify studies.…”

“…Four studies with five effect sizes [ 14 , 15 , 17 , 30 ] examined the effect of SO tamponade on the CMT after SO removal compared to gas tamponade in patients with RRD. The SO tamponade could significantly reduce the CMT (WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I 2 = 71%) compared to gas tamponade in patients with RRD, with substantial heterogeneity between studies (Fig.…”

“…Moreover, a study by Karimi et al showed that the subfoveal choroidal thickness (SFCT) was reduced in patients receiving SO tamponade [ 16 ]. Conversely, a study by Zhou et al reported a decrease in the retinal layer thickness, while no significant change was observed in the choroidal thickness [ 17 ].…”

Silicone oil versus gas tamponade for primary rhegmatogenous retinal detachment treated successfully with a propensity score analysis: Japan Retinal Detachment Registry

“…[13][14][15] It has also been reported that unexplained visual impairments occurred from damages to retinal structures in eyes treated with SOT. [16][17][18] There are also reports that eyes with non-complex RD treated by SOT had poorer postoperative retinal sensitivity and visual acuity than eyes treated by GT. 19 20 Thus, there is a concern that the toxicity of silicone oil may be greater than that reported.…”

Effect of Retina Detachment Surgery at Long Time on Macular Microvascular Structure: An Optical Coherencetomographyangiography Study

“…After a long follow-up period, lower values of VD were measured than the control eyes in the macula. Zhou et al showed that SO had a more negative effect on vasculature and structure of the super cial, deep and choriocapillaris plexus when compared to gas [17].…”