Royal Brisbane and Women's Hospital Ophthalmology Department, Level 8, Ned Hanlon Building, Brisbane, QLD, 4029, Australia.
FRANZCO, Brisbane, Australia.
Int Ophthalmol. 2023 May;43(5):1477-1486. doi: 10.1007/s10792-022-02544-7. Epub 2022 Oct 13.
Presumed silicone oil-related retinal toxicity causes central vision loss with a reported incidence of 1-33% in the first month after oil removal and 10% in the first six months of having silicone oil in-situ. This report examines local rates in a tertiary hospital that manages many geographically distanced patients. A miniature literature review, audit and case series are presented.
A retrospective audit of all patients who underwent a 'removal of silicone oil' surgery at the Royal Brisbane and Women's Hospital between 2016 and 2021. Inclusion criteria were that the oil was inserted for primary or recurrent rhegmatogenous retinal detachment. Visual acuity was analysed at presentation, at 1 and 3 months of oil in-situ, preoperatively to removal of oil and up to 6 months after oil removal. Ocular coherence tomographic parameters were examined at each time interval, including nerve fibre layer (NFL) and ganglion cell layer and inner plexiform layer (GCL + IPL) thicknesses in the 3 mm parafoveal zone, presence of inner retinal microcystic changes or intraretinal silicone oil globules. Patients were identified who had unexplained vision loss of two or more Snellen lines. Further analysis and case review were performed.
Between January 2016 and May 2021, 101 patients met the inclusion criteria. Three patients had significant and unexplained visual loss. They are presented in this paper. Presumed silicone oil toxicity is an increasingly recognised and potentially devastating phenomenon that vitreo-retinal surgeons should be wary of. Patients should be specifically consented for it and hospitals should perform local auditing to determine their own rates and inform this discussion.
硅油相关的推定视网膜毒性在硅油取出后第一个月的发生率为 1-33%，在硅油原位存在的前六个月的发生率为 10%，导致中心视力丧失。本报告检查了一家管理许多地理位置分散患者的三级医院的本地发生率。报告介绍了微型文献复习、审计和病例系列。
对 2016 年至 2021 年期间在皇家布里斯班妇女医院接受“硅油取出”手术的所有患者进行回顾性审计。纳入标准为硅油插入用于原发性或复发性孔源性视网膜脱离。视力在就诊时、硅油原位 1 个月和 3 个月、硅油取出前和硅油取出后 6 个月进行分析。在每个时间间隔检查眼部相干断层扫描参数，包括神经纤维层（NFL）和节细胞层和内丛状层（GCL+IPL）在 3mm 旁中心区的厚度、内视网膜微囊变化或视网膜内硅油小滴的存在。确定了视力丧失两个或更多 Snellen 线的不明原因的患者。进一步进行了分析和病例回顾。
2016 年 1 月至 2021 年 5 月期间，有 101 名患者符合纳入标准。有 3 名患者视力明显且不明原因下降。本文介绍了这 3 名患者。硅油毒性是一种越来越被认识到的潜在破坏性现象，玻璃体视网膜外科医生应该对此保持警惕。应专门为此向患者说明，并由医院进行本地审计，以确定其自身的发生率并为讨论提供信息。
