Department of Ophthalmology and Visual Neurosciences, University of Minnesota Medical School.
Department of Ophthalmology, Minneapolis VA Health Care System, Minneapolis, Minnesota, U.S.A.
Ophthalmic Plast Reconstr Surg. 2019 Mar/Apr;35(2):e31-e34. doi: 10.1097/IOP.0000000000001300.
The authors report the case of a 75-year-old man with preexisting glaucoma and recurrent retinal detachment who underwent intraocular silicone oil placement OD resulting in subsequent retrolaminar silicone oil migration to the optic chiasm and vision loss OS. MRI showed silicone oil tracking posteriorly along the right optic nerve to the chiasm. He was placed on high-dose corticosteroids and underwent a successful optic nerve sheath fenestration with improvement of vision in the contralateral eye. Clinicians should be cognizant of the potential for translaminar posterior migration of intraocular silicone oil, as well as the utility of optic nerve sheath fenestration to decompress the anterior visual pathways and restore vision.
作者报告了一例 75 岁男性病例，该患者患有青光眼和复发性视网膜脱离，接受了右眼眼内硅油填充，随后发生硅油向后迁移至视交叉并导致左眼视力丧失。MRI 显示硅油沿右眼视神经向后追踪至视交叉。患者接受了大剂量皮质类固醇治疗，并成功进行了视神经鞘开窗术，对侧眼视力有所改善。临床医生应意识到眼内硅油向后穿过视盘的潜在风险，以及视神经鞘开窗术对视前通路进行减压并恢复视力的作用。
