OPTICAL COHERENCE TOMOGRAPHIC PATTERNS OF POSTERIOR SEGMENT STICKY HEAVY SILICONE OIL

To describe unique optical coherence tomography observations of adherent preretinal heavy silicone oil after removal.

Retrospective observational review of files and optical coherence tomography scans of patients who had pars plana vitrectomy with heavy silicone oil. We investigated the possible precipitating preoperative and intraoperative factors and the association with postoperative epiretinal membrane and cystoid macular edema.

Forty-one eyes from 39 patients were involved. Two characteristic sticky silicone oil structures were identified in 33 patients (80%): variably reflective macrodroplets (bubbles) and hyperreflective microdroplets (dots). The main contributing variable was the tamponade duration. Other notable associations included postoperative epiretinal membrane and cystoid macular edema formation. Surgical interventions including heavy liquid did not show a strong predilection to their development. We reported two novel findings of sticky prefoveal macrodroplets in five patients and intravitreal macrodroplets and microdroplets casting shadows on the underlying retina in four patients.

This study confirms previously reported optical coherence tomography observations of sticky emulsified silicone oil remnants after removal. This is the first report of two distinctly different optical coherence tomography appearances after heavy silicone oil removal. The variability in size and reflectivity may be attributed to the amount and nature of the induced inflammatory reaction.