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. 2019 Nov;3(6):466-473.
doi: 10.1177/2474126419875298. Epub 2019 Sep 25.

Intravitreal Silicone Oil Migration Into the Lateral Cerebral Ventricles

Jessica L Cao  1   2 , Andrew W Browne  3   4 , Thomas Clifford  2 , Sumit Sharma  1 , Vivek Patel  4
Affiliations

Intravitreal Silicone Oil Migration Into the Lateral Cerebral Ventricles

Jessica L Cao et al. J Vitreoretin Dis. 2019 Nov.

Abstract

Purpose: Silicone oil (SO) is often used as an intraocular tamponade in repairs of retinal detachments. It may be associated with complications such as cataract, glaucoma, keratopathy, subretinal migration of oil, fibrous epiretinal and sub retinal proliferations, and oil emulsification. The purpose of this report is to describe a rare phenomenon of intraocular silicone oil migration into the cerebral ventricles, which may later be mistaken for intraventricular hemorrhages on neuroimaging.

Methods: Case report with literature review.

Results: A patient with a history of retinal detachment repair with intraocular SO presented with headaches. Neuroimaging revealed SO migration to the cerebral ventricles. The patient was treated conservatively with symptom management and headaches resolved.

Conclusions: We present a case of intraocular SO migration to the cerebral ventricles and review the current literature. We also propose two mechanisms for this phenomenon.

Keywords: complications of vitreoretinal surgery; retinal detachment; silicone oil.

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Conflict of interest statement

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The right eye is half full of silicone oil, while the left eye is 80% to 90% full. Axial noncontrast computed tomography of the head shows (A) bilateral hyperdense bodies in the frontal horns of the lateral ventricles, (B) a hyperattenuating body in the left anterior aspect of the suprasellar cistern (arrowhead), and (C) relative hyperlucency along the right optic sheath (arrow).
Figure 2.
Figure 2.
Axial noncontrast head computed tomography scan with the patient in prone position. Hyperlucent bodies previously in the anterior horns have moved dorsally to (A) the left atrium of the lateral ventricle (arrowhead) as well as (B) the right atrium (arrow).
Figure 3.
Figure 3.
B-scan ultrasonography. (A) The right eye with a half volume of silicone oil shows normal echogenicity of the lower half of the eye in the vertical axial scan, and delayed echogenicity with posteriorly displaced retinal image in the upper half of the eye. (B) B-scan of the left eye demonstrates profound optic nerve cupping (arrow).
Figure 4.
Figure 4.
(A) An indirect pathway shows how cerebrospinal fluid (CSF) may flow from perioptic space to the fourth ventricle via retrograde flow through the foramina of Magendie or Luschka. (B) A direct pathway postulates that CSF flows transmembranously from perioptic subarachnoid space to the lamina terminalis.
See this image and copyright information in PMC

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