EURETINA 2024: Factors predictive of macular edema development in patients with silicone oil tamponade
Additional previous surgeries and the duration of the SO tamponade had little or no impact
Enrico Bernardi, MD, from the University Hospital of Bern, Bern, Switzerland, and colleagues reported that retinectomy had a significant effect on the development of macular edema (ME) in patients who received a silicone oil (SO) tamponade.
The investigative team conducted a single-centre study to determine the factors that might predict the development of ME in patients who underwent pars plana vitrectomy and silicone oil (SO) as tamponade.
Their study was an observational, comparative, and retrospective review of patients who received SO tamponade to treat a rhegmatogenous retinal detachment (RRD) or macular hole.
(Image credit: AdobeStock/Parilov)
The investigators collected and analysed the patients’ demographic and clinical features that included age, gender, diagnosis, macular status, lens status, previous retinal surgeries, presence of proliferative vitreoretinopathy (PVR), retinectomy, type of SO, duration of tamponade, best-corrected visual acuity, central macular thickness (CMT) and follow-up.
The main outcome measure was the development of ME during and after SO tamponade.
The study included 114 patients (average age, 60 years), most of whom were men (69%). Most of the patients, 85%, had a RRD (85%), about three-quarters of which were macula-off. Most patient had PVR.
The analysis found that ME developed in 54% of eyes. The mean CMT was 443 μm in the presence of ME and 274 μm without ME (p > 0.0001). Following removal of the SO, the CMT decreased in the group with ME to 362 μm; in the group without ME, the CMT was 292 μm (p = 0.019), the authors reported.
The ME was not responsive to topical treatments that included steroids, anti-inflammatory agents and carbonic anhydrase inhibitors.
The study patients had an average follow-up of 104 weeks. Patients who underwent retinectomy had an increased odds of development of ME by about 2.6 times (odds ratio [OR], 2.614). Interestingly, the macula-on status of the RRD markedly reduced the OR (OR, 0.2104), suggesting that it provided a protective effect. The variables analysed that had little or no impact were additional previous surgeries (OR, 1.07) and the duration of the SO tamponade (OR, 0.99).
Bernardi and colleagues concluded, “Our study highlights the significant influence of retinectomy on the development of ME in patients who received a SO tamponade. This correlation was proven to be much more important than the duration of the SO tamponade itself. Treatment strategies should be investigated and refined in this complex context.”
