Value of Optical Coherence Tomography in The Detection of Macular Changes in Silicone Filled Eye

Background: Silicone oils (SO) are successfully used as intraocular tamponade due to their ability to maintain adhesion between the retina and retinal pigment epithelium (RPE). Aim of the Study: To evaluate the effectiveness of Optical coherence tomography (OCT) in identifying macular alterations following SO use and its potential impact on decision-making regarding the timing of silicone oil removal in silicone-filled eyes. Patients and Methods: This prospective observational study with analytical components included 40 patient eyes that underwent pars plana vitrectomy and silicone oil tamponade (5000 cs) for complicated retinal detachment. All patients underwent OCT within 2 weeks after silicone injection, at 3 months, and finally at 6 months to assess macular thickness, detect changes, and assess retinal nerve fiber layer (RNFL) thickness. The study was conducted at the Ophthalmology Division of Al-Azhar University Hospitals. Results: The study comprised 40 patients (40 eyes) aged 15-73 years (mean 53.78 ± 14.33 years). There were 22 males (55%) and 18 females (45%). OCT findings at 6 months post-operation showed normal findings in 14 eyes. Six eyes had epiretinal membranes, six had disrupted inner/outer segments, five had foveal thinning, five had cystoid macular edema, four had diffuse macular edema, and two had a macular hole. Conclusion: Performing non-contact OCT before silicone oil removal helps predict visual outcome by detecting macular pathologies. It is useful for altering surgical strategy to address treatable macular diseases. OCT can detect macular edema and thinning undetectable clinically or intraoperatively during silicone oil removal.