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Correspondence to Author: Dr.Patricio S. Espinosa, 

Centro Internacional en Neurociencias, 5 Finch Ln, Mandeville

Abstract:

For the difficult retinal detachment treatment known as ocular endotamponade, silicone oils are employed. It is rare for silicone oil endotamponade to cause neurological problems. According to case reports, silicone oil migrated into the subarachnoid space and ventricular system, causing optic nerve atrophy. Optic neuritis lateral to the treated eye, however, has not previously been documented. We describe a 60-year-old woman who had silicone oil used to heal a retinal detachment in her left eye, but who afterwards experienced optic neuritis in her right eye. The patient immediately complained of excruciating pain in the left orbit that had spread to the left temporal and occipital regions following the silicone oil injection. She then experienced vision loss in her right eye, which had not previously been afflicted. She was given a hefty dose of steroids intravenously. for three days before the right eye’s vision completely recovered. Two weeks later, she experienced a second episode of blurry vision in her right eye, but this time, it didn’t get better. Inflammation on the optic nerves and silicone oil in the ventricular system are both visible on MR imaging. Conclusions: Silicone oil has the potential to enter the nerve system and cause optic neuritis in the opposite eye.

Introduction: In order to treat difficult retinal detachments, silicone oils (polymethylsiloxanes) are employed for ocular endotamponade [1]. It is rare for silicone oil endotamponade to cause neurological problems. Case studies have shown silicone oil migration into the subarachnoid space and ventricular system, as well as optic nerve atrophy [2–7]. Optic neuritis lateral to the treated eye, however, has not previously been documented. We describe a patient who had silicone oil injected into the left eye to treat a retinal detachment who afterwards experienced blindness in the opposite eye. Radiographic findings also showed silicone oil migration into the central nervous system.

CONCLUSIONS:The migration of silicone oil into the nerve system can result in visual neuritis. Clinicians need to be aware of silicone oil endotamponate’s neurological side effects. The likelihood of silicone oil migrating into the central nervous system should be raised in the presence of symptoms including refractory ocular pain, headache, ptosis, change in mental status, and deteriorating vision loss (ipsilateral and/or contralateral).

REFERENCES:1. Heimann H, Stappler T, Wong D (2008) Heavy tamponade 1: a review of indications, use, and complications. Eye 22: 1342-1359. 2. Fangtian D, Rongping D, Lin Z, Weihong Y (2005) Migration of intraocular silicone into the cerebral ventricles. Am J Ophthalmol 140: 156-158. 3. Eller AW, Friberg TR, Mah F (2000) Migration of silicone oil into the brain: a complication of intraocular silicone oil for retinal tamponade. Am J Ophthalmol 129: 685-688. 4. Kuhn F, Kover F, Szabo I, Mester V (2006) Intracranial migration of silicone oil from an eye with optic pit. Graefes Arch Clin Exp Ophthalmol 244: 1360-1362 5. Papp A, Toth J, Kerenyi T, Jackel M, Suveges I (2004) Silicone oil in the subarachnoidal space--a possible route to the brain? Pathol Res Pract 200: 247-252 6. Yu JT, Apte RS (2005) A case of intravitreal silicone oil migration to the central nervous system. Retina 25: 791- 793 7. Williams RL, Beatty RL, Kanal E, Weissman JL (1999) MR imaging of intraventricular silicone: case report. Radiology 212: 151-154. 8. Taherian K, Bishop F, Woon WH, Nelson M (2004) Silicone oil endotamponade is it safe? Eye 18: 649-650. 9. Wickham L, Asaria RH, Alexander R, Luthert P, Charteris DG (2007)Immunopathology of intraocular silicone oil: enucleated eyes. Br J Ophthalmol 91: 253-257. 10. Biswas J, Verma A, Davda MD, Ahuja S, Pushparaj V. (2008) Intraocular tissue migration of silicone oil after silicone oil tamponade: a histopathological study of enucleated silicone oil-filled eyes. Indian J Ophthalmol 56: 425-428. 11. Donker DL, Paridaens D, Mooy CM, van den Bosch WA (2005) Blepharoptosis and upper eyelid swelling due to lipogranulomatous inflammation caused by silicone oil. Am J Ophthalmol 140: 934-936. 12. Quintyn JC, Genevois O, Ranty ML, Retout A (2003) Silicone oil migration in the eyelid after vitrectomy for retinal detachment. Am J Ophthalmol 136: 540-542.

Citation:

Dr.Patricio S. Espinosa. AFollowing silicone oil endotamponade for retinal detachment, there was contralateral optic neuritis. Journal of Psychiatry Research 2024.