Visusminderung unter Silikon

Zusammenfassung

Silikonöl wird als Tamponade in der Behandlung komplexer Netzhautablösungen mit proliferativer Vitreoretinopathie verwendet. In letzter Zeit tauchten Fallserien auf, die einen zentralen Visusverlust nach Amotiochirurgie mit Silikonöl beschreiben, trotz scheinbar guter Visusprognose. In verschiedenen Berichten wurde die Migration von Silikonöl in Netzhaut und Sehnerv nachgewiesen, in Tierexperimenten der großflächige Verlust myelinisierter Sehnervenfasern beobachtet. Diese Fallberichte und mögliche Mechanismen des Visusverlusts nach Silikonöl werden besprochen. Letztendlich sollte die zusätzliche Gefahr eines zentralen Visusverlusts miteinbezogen werden, wenn die Entscheidung zwischen Silikonöl und Gas als intravitreale Tamponade zu treffen ist.

Abstract

Silicone oil is used as intravitreal tamponading agent in surgery for rhegmatogenous retinal detachment (RRD) cases complicated with proliferative vitreoretinopathy (PVR). Recently, a number of case series have appeared where profound central visual loss has been found in eyes after uncomplicated vitrectomy with silicone tamponade for RRD in eyes with seemingly good visual potential. Several reports have demonstrated the migration of silicone oil droplets into the retina and the optic nerve, others the widespread loss of myelinated optic nerve fibres. These reports are reviewed, and it is concluded that caution is warranted when silicone oil is used in eyes with good visual potential. Finally the additional danger of central visual loss should be taken into consideration when deciding to use silicone oil or gas as intravitreal tamponade.

Netzhautablösung - Silikonöl - proliferative Vitreoretinopathie

retinal detachment - silicone oil - proliferative Vitreoretinopathy

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