Seeing Floaters: A Case Report and Literature Review of Intraventricular Migration of Silicone Oil Tamponade Material for Retinal Detachment

World Neurosurg. 2018 Jul:115:201-205. doi: 10.1016/j.wneu.2018.04.049. Epub 2018 Apr 17.

Abstract

Background: Intraocular injection of silicone oil is commonly performed during vitrectomy to tamponade the retina in place for treatment of retinal detachment. Although rare, this intravitreal silicone can migrate through the optic nerve and chiasm and enter the cerebral ventricles.

Case description: Here we present a case report of a patient presenting with headache and intraventricular hyperdensities on a computed tomography (CT) scan, raising a concern for intraventricular hemorrhage. However, the intraventricular hyperdensities were in a nondependent location and moved to a new nondependent location when repeat imaging was performed with the patient in the prone position. We provide a literature review of this phenomenon and discuss the relevant CT and magnetic resonance imaging findings.

Conclusions: Intraocular silicone can rarely migrate into the cerebral ventricular system. Careful review of the clinical history and imaging findings can help distinguish this from other, more dangerous intracranial pathologies.

Keywords: Intraocular silicone oil tamponade; Intraventricular hemorrhage; Intraventricular migration; Retinal detachment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebral Ventricles / diagnostic imaging*
  • Female
  • Foreign-Body Migration / chemically induced
  • Foreign-Body Migration / diagnostic imaging*
  • Humans
  • Injections, Intraocular / adverse effects
  • Middle Aged
  • Retinal Detachment / diagnostic imaging*
  • Retinal Detachment / drug therapy*
  • Silicone Oils / administration & dosage
  • Silicone Oils / adverse effects*
  • Vision Disorders / chemically induced
  • Vision Disorders / diagnostic imaging*

Substances

  • Silicone Oils