Dynamic biological macular vascular changes of silicon oil tamponade in patients with rhegmatogenous retinal detachment

  • Jing Cheng Ophthalmology Department, Hunan Medical College General Hospital, Huaihua 418099, China
  • Nian Li Ophthalmology Department, Hunan Medical College General Hospital, Huaihua 418099, China
  • Lan Yu Ophthalmology Department, Hunan Medical College General Hospital, Huaihua 418099, China
  • Qi Zeng Ophthalmology Department, Hunan Provincial People’s Hospital (First Affiliated Hospital of Hunan Normal University), Changsha 410011, China
Keywords: retinal detachment; pars plana vitrectomy; silicone oil; optical coherence tomography; macular vasculature
Article ID: 1703

Abstract

Pars Plana Vitrectomy (PPV), combined with intravitreal tamponade Silicone Oil (SO), is one of the most popular and effective surgical interventions for Rhegmatogenous Retinal Detachment (RRD), achieving high rates of anatomic reattachment. However, long-term SO Tamponade (SOT) can induce structural and microcirculation alterations, affecting visual function, even after SO Removal (SOR). Therefore, for an appropriate SO Filling (SOF) duration, we investigated the dynamic changes of macular vasculature during SOF and after SOR. 51 eyes (51 patients) with macular-on RRD underwent single PPV and were randomly divided into 2 groups according to intravitreal SOT duration, either for 2 or 3 months. Optical Coherence Tomography (OCT) and angiography were used to evaluate the macular perfusion system, which was segmented into Superficial and Deep Capillary Plexus Flow Density (SCPFD, DCPFD) and Choriocapillaris Plexus Flow Density (CCPFD). The VA (VA) and the flow density were measured at 1 week, 1 month, 2 months, and 3 months SOF, and 1 week and 1 month post SOR. Both 2- and 3-month SOT strongly reduced VA, particularly in the first month. There was no significant difference in VA between the two groups during the opinion. Compared with that before the surgery, the VA had a 51% reduction after 2 months and a 57% reduction after 3 months of SOF, which was not recovered even after a 1-month SOR. 2-month SOT did not significantly affect macular microvascular. However, SCPED was starkly suppressed at 3-month SOF, following a significant increase after 1-month SOR. Moreover, 2-month SOT caused slight changes in macular microcirculation during the observation, together with a fast recovery of VA after 1-week SOR, about 90% of VA at 1-week SO. However, the flow densities in all three segmented layers upon 3-month SOT were correlated with each other, showing the same fluctuation trend, i.e., strong suppression at 3-month SO and slow recovery after SOR, which a low VA accompanied after 1-week SOR, about 50% of VA at 1-week SOT. Either 2- or 3-month SOT reduced VA of RRD eyes. However, unlike 2-month SOF, 3-month SOT could induce strong suppression of macular microcirculation, which might be detrimental to VA recovery of RRD eyes after PPV surgery. Therefore, a 2-month SO might be an appropriate time for SOR to achieve a better functional recovery of RRD.

References

1. Warren A, Wang DW, Lim JI. Rhegmatogenous retinal detachment surgery: A review. Clinical Exper Ophthalmology. 2023; 51(3): 271–9.

2. Lin JB, Narayanan R, Philippakis E, et al. Retinal detachment. Nat Rev Dis Primers. 2024; 10(1): 18.

3. Al-Shehri AM, Aljohani S, Aldihan KA, et al. Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment. BMC Ophthalmol. 2024; 24(1): 119.

4. Pieczynski J, Kuklo P, Grzybowski A. Pars plana vitrectomy with silicone oil tamponade for primary and secondary macular hole closure: Is it still a useful procedure? European Journal of Ophthalmology. 2018; 28(5): 503–14.

5. Franks WA, Leaver PK. Removal of silicone oil—Rewards and penalties. Eye. 1991; 5(3): 333–7.

6. Lappas A, Dietlein T, Rosentreter A, et al. Visusverlust nach Silikonölchirurgie. Klin Monatsbl Augenheilkd. 2018; 235(06): 725–9.

7. Scheerlinck LM, Schellekens PA, Liem AT, et al. Incidence, Risk Factors, And Clinical Characteristics Of Unexplained Visual Loss After Intraocular Silicone Oil For Macula-On Retinal Detachment. Retina. 2016; 36(2): 342–50.

8. Al-Wadani SF, Abouammoh MA, Abu El-Asrar AM. Visual and anatomical outcomes after silicone oil removal in patients with complex retinal detachment. Int Ophthalmol. 2014; 34(3): 549–56.

9. Salehi A, Malekahmadi M, Karimi A, Beni AN. Retinal vascular changes after Silicon Oil removal in the Eye with Rhegmatogenous Retinal detachment. Int J Retin Vitr. 2024; 10(1): 68.

10. Ghanbari H, Kianersi F, Jamshidi Madad A, et al. The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis. Int J Retin Vitr. 2021; 7(1): 76.

11. Chen HJ, Tsai YL, Hsiao CH, Chang CJ. Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis. Ophthalmic Res. 2023; 767–76.

12. Yan Y, Liu R, Gao C, et al. Effects of refractive accommodation on subfoveal choroidal thickness in silicone oil-filled eyes. BMC Ophthalmol. 2022; 22(1): 107.

13. Christou EE, Papaconstantinou D, Droutsas K, et al. Effect of silicone oil on retinal microcirculation after vitrectomy for rhegmatogenous retinal detachment evaluated by OCT angiography: a literature review. Ophthalmol Eye Dis. 2023.

14. Country MW. Retinal metabolism: A comparative look at energetics in the retina. Brain Research. 2017; 1672: 50–7.

15. Gironi M, D’Aloisio R, Verdina T, et al. Long-Term Macular Vascular Changes after Primary Rhegmatogenous Retinal Detachment Surgery Resolved with Different Tamponade or Different Surgical Techniques. Life. 2022; 12(10): 1525.

16. Pichi F, Hay S, Abboud EB. Inner retinal toxicity due to silicone oil: a case series and review of the literature. Int Ophthalmol. 2020; 40(9): 2413–22.

17. Williamson TH, Shunmugam M, Rodrigues I, et al. Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome. Eye. 2013; 27(9): 1063–9.

18. Zhou Y, Zhang S, Zhou H, et al. Comparison of fundus changes following silicone oil and sterilized air tamponade for macular-on retinal detachment patients. BMC Ophthalmol. 2020; 20(1): 249.

19. Tang W, Guo J, Liu W, Xu G. Quantitative analysis of retinal and choriocapillary vascular density of multiple evanescent white dot syndrome by optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol. 2020; 258(8): 1697–707.

20. Silvaroli JA, Widjaja-Adhi MAK, Trischman T, et al. Abnormal Cannabidiol Modulates Vitamin A Metabolism by Acting as a Competitive Inhibitor of CRBP1. ACS Chem Biol. 2019; 14(3): 434–48.

Published
2025-03-24
How to Cite
Cheng, J., Li, N., Yu, L., & Zeng, Q. (2025). Dynamic biological macular vascular changes of silicon oil tamponade in patients with rhegmatogenous retinal detachment. Molecular & Cellular Biomechanics, 22(5), 1703. https://doi.org/10.62617/mcb1703
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Article