Retrospective Study on Changes in Optic Disc Structure, Macular Perfusion, and Ganglion Cell Complex Following Pars Plana Vitrectomy Combined with Silicone Oil Tamponade
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i1.5050
Abstract
Objective: To evaluate the dynamic changes in optic disc structure, macular blood flow perfusion, and ganglion cell complex (GCC) before and after pars plana vitrectomy (PPV) combined with silicone oil (SO) tamponade. Methods: This retrospective study enrolled 35 eyes of patients with rhegmatogenous retinal detachment (RRD) who underwent PPV combined with SO tamponade at Ningbo Eye Hospital between January 2023 and December 2025. Optical coherence tomography angiography (OCTA) examinations were performed preoperatively, during the silicone oil in situ period (3 months postoperatively), and at 3 months after silicone oil removal. Optic disc structural parameters, macular superficial and deep capillary plexus (SCP/DCP) vessel density, and GCC thickness were compared across time points. Results: Best-corrected visual acuity (BCVA) improved continuously from the preoperative period through oil removal (all P < 0.05). Intraocular pressure (IOP) increased during the oil-in period and returned to baseline after removal (P = 0.969). No statistically significant differences were observed in optic disc cup-to-disc ratio, rim area, or retinal nerve fiber layer (RNFL) thickness between the oil-in period and post-removal (all P > 0.05). DCP vessel density decreased significantly after oil removal compared to the oil-in period (37.54% vs. 33.78%, P = 0.006), while SCP showed no significant difference. GCC thickness increased significantly after oil removal compared to the oil-in period (85.28 vs. 89.60 μm, P = 0.014). Conclusions: Deep retinal microcirculation continued to decline after silicone oil removal, suggesting the presence of persistent deep retinal damage. GCC thickening may reflect correction of measurement bias during the oil-in period and partial structural recovery of ganglion cells. Clinically, vigilant IOP monitoring and evaluation of macular deep perfusion during the oil-in period are warranted, along with timely removal of silicone oil.
Keywords
pars plana vitrectomy; silicone oil tamponade; optical coherence tomography angiography; ganglion cell complex; deep capillary plexus
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[9] Ozal E, Guler MS, Karapapak M, et al. Beyond the surface: investigating silicone oil's impact on macular perfusion in macula-off rhegmatogenous retinal detachment via OCTA. Retina. Publish Ahead of Print. doi:10.1097/IAE.0000000000004364
[10] Lei B, Chen X, Zhou M, et al. Outcomes after silicone oil removal in patients with acute retinal necrosis who underwent vitrectomy. Ocul Immunol Inflamm. 2025. doi:10.1080/09273948.2025.2477193
[2] Januschowski K, Rickmann A, Smith J, et al. Vision loss associated with silicone oil endotamponade in vitreoretinal surgery – a review. Graefes Arch Clin Exp Ophthalmol. 2024;262:3453–3463. doi:10.1007/s00417-024-06520-y
[3] Sinisi F, Della Santina M, Loiudice P, et al. The role of silicone oil in the surgical management of endophthalmitis: a systematic review. J Clin Med. 2022;11(18):5445. doi:10.3390/jcm11185445
[4] Chikmah FA, Ichsan AM, Islam IC, et al. Retinal nerve fiber layer changes after intraocular silicone oil tamponade in rhegmatogenous retinal detachment. Vision. 2023;7(1):13. doi:10.3390/vision7010013
[5] Zoric Geber M, Bencic G, Vatavuk Z, et al. Retinal nerve fibre layer thickness measurements after successful retinal detachment repair with silicone oil endotamponade. Br J Ophthalmol. 2015;99(6):853–858. doi:10.1136/bjophthalmol-2014-305839
[6] Caramoy A, Droege KM, Kirchhof B, et al. Retinal layers measurements in healthy eyes and in eyes receiving silicone oil-based endotamponade. Acta Ophthalmol. 2014;92:e292–e297. doi:10.1111/aos.12307
[7] Ma Y, Zhu XQ, Peng XY. Macular perfusion changes and ganglion cell complex loss in patients with silicone oil-related visual loss. Biomed Environ Sci. 2020;33(3):151–157. doi:10.3967/bes2020.021
[8] Ozsaygili C, Bayram N. Effects of different tamponade materials on macular segmentation after retinal detachment repair. Jpn J Ophthalmol. 2021;65(2):227–236. doi:10.1007/s10384-020-00800-w
[9] Ozal E, Guler MS, Karapapak M, et al. Beyond the surface: investigating silicone oil's impact on macular perfusion in macula-off rhegmatogenous retinal detachment via OCTA. Retina. Publish Ahead of Print. doi:10.1097/IAE.0000000000004364
[10] Lei B, Chen X, Zhou M, et al. Outcomes after silicone oil removal in patients with acute retinal necrosis who underwent vitrectomy. Ocul Immunol Inflamm. 2025. doi:10.1080/09273948.2025.2477193
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