View abstract

This abstract is assigned to session Poster session

Title	A case report : unanticipated vision loss after removal of silicone oil by pars plana vitrectomy
Abstract Nr.	P123

Purpose	To report a case of acute central vision loss after removal of silicone oil by pars plana vitrectomy for a peripheral giant tear of the retina with a safe macula
Methods	A sixty-seven years old male with a peripheral giant tear of the retina and a safe macula treated by pars plana vitrectomy with silicone oil. The patient is pseudophakic. The follow-up includes full ophtalmological work up with visual field, FA, OCT, VEP and multifocal ERG.
Results	Pre-operative BCVA is 8/10 (Snellen chart) RE and 3 months after silicone oil is removed, BCVA is 1/20. Humphrey visual field presents a paracentral scotoma with loss of fixation (MD = -2.07dB). OCT confirmes an extensive loss of retinal cells density, especially in the external nuclear layer. VEP have normal latencies wich exclude optic nerve disease. Multifocal ERG confirms macular dysfunction. After 6 months follow-up, BCVA spontaneous increases to 4/10 and paracentral scotoma decreases on the visual field
Conclusion	Our clinical case presents a spontaneous improvement of visual loss after vitrectomy with silicone oil, probably in relation with a toxic maculopathy. Possible etiologies include electrolyte shifts within the vitreous cavity, within the retina, intraoperative phototoxicity, environmental light phototoxicity during silicone oil tamponade as the result of poor short wavelenght filtering by silicone oil and direct retinal toxicity. Morever, this phenomen is probably potentialized in pseudophakic patient. More studies should be done to understand this vision loss associated with the use or removal of silicone oil

Authors 1

Last name	FORTUNATI
Initials	M
Department	Université catholique de Louvain
City	Brussels

Authors 2

Last name	BOSCHI
Initials	A
Department	Université catholique de Louvain
City	Brussels