Letter to the Editor In Reply to “Intraocular Silicone Oil Migration into the Ventricles Resembling Intraventricular Hemorrhage: Case Report and Review of the Literature”
LETTER: e have read with interest the article by Filippidis et al.1 We absolutely agree with the authors when they say that clinicians should be aware of this rare disorder and that meticulous history-taking and assessment of patient presentation help to ensure a correct diagnosis. Nevertheless, they provide no information about the aspect of the optic disc, the intraocular pressure (IOP) of the patient, or the type and viscosity of the silicone oil (SiO) used. These clinical data regarding the presence of any of these predisposing factors in this patient are important because they might have played a crucial role in physical SiO migration.2-4
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We would also like to congratulate the authors for the differential diagnosis with an intraventricular hemorrhage and the successful conservative management of such a rare complication; however, some discussion is needed. Although elevated intraocular pressure and congenital optic nerve abnormalities seem to play an important role in the etiopathology of this complication, it is necessary to clarify that the reduced visual acuity and nonreactive pupil in the left eye of the patient was secondary to the previous retinal detachment and subsequent surgical repair, but not related to the
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intracranial SiO migration. Furthermore, the expression “silicone oil implant” is not appropriate. The authors should refer to “silicone oil placement” because this endotamponade agent is not an implant but a viscous liquid. Francisco J. Ascaso1,2 and Andrzej Grzybowski3,4 From the 1Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; 2Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain; 3Department of Ophthalmology, Poznan City Hospital, Poznan, Poland; and 4Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland To whom correspondence should be addressed: Andrzej Grzybowski, M.D., Ph.D. [E-mail: [email protected]] The study was partly funded by the Foundation for Ophthalmology Development, Poznan, Poland. http://dx.doi.org/10.1016/j.wneu.2017.04.158.
REFERENCES 1. Filippidis AS, Conroy TJ, Maragkos GA, Holsapple JW, Davies KG. Intraocular silicone oil migration into the ventricles resembling intraventricular hemorrhage. Case report and review of literature. World Neurosurg. 2017;102:695.e7-695.e10. 2. Grzybowski A, Pieczynski J, Ascaso FJ. Neuronal complications of intravitreal silicone oil. An updated review. Acta Ophthalmol. 2014;92:201-204. 3. Grzybowski A, Ascaso FJ. Migration of intraocular silicone oil to CNS: the role of elevated intraocular pressure and congenital optic nerve abnormalities. Clin Neuroradiol. 2016;26:127. 4. Ascaso FJ, Grzybowski A. Subarachnoidal migration of intraocular silicone oil. Acta Neurochir (Wien). 2017;159:807.
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LETTER: e have read with interest the article by Filippidis et al.1 We absolutely agree with the authors when they say that clinicians should be aware of this rare disorder and that meticulous history-taking and assessment of patient presentation help to ensure a correct diagnosis. Nevertheless, they provide no information about the aspect of the optic disc, the intraocular pressure (IOP) of the patient, or the type and viscosity of the silicone oil (SiO) used. These clinical data regarding the presence of any of these predisposing factors in this patient are important because they might have played a crucial role in physical SiO migration.2-4
W
We would also like to congratulate the authors for the differential diagnosis with an intraventricular hemorrhage and the successful conservative management of such a rare complication; however, some discussion is needed. Although elevated intraocular pressure and congenital optic nerve abnormalities seem to play an important role in the etiopathology of this complication, it is necessary to clarify that the reduced visual acuity and nonreactive pupil in the left eye of the patient was secondary to the previous retinal detachment and subsequent surgical repair, but not related to the
1006
www.SCIENCEDIRECT.com
intracranial SiO migration. Furthermore, the expression “silicone oil implant” is not appropriate. The authors should refer to “silicone oil placement” because this endotamponade agent is not an implant but a viscous liquid. Francisco J. Ascaso1,2 and Andrzej Grzybowski3,4 From the 1Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; 2Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain; 3Department of Ophthalmology, Poznan City Hospital, Poznan, Poland; and 4Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland To whom correspondence should be addressed: Andrzej Grzybowski, M.D., Ph.D. [E-mail: [email protected]] The study was partly funded by the Foundation for Ophthalmology Development, Poznan, Poland. http://dx.doi.org/10.1016/j.wneu.2017.04.158.
REFERENCES 1. Filippidis AS, Conroy TJ, Maragkos GA, Holsapple JW, Davies KG. Intraocular silicone oil migration into the ventricles resembling intraventricular hemorrhage. Case report and review of literature. World Neurosurg. 2017;102:695.e7-695.e10. 2. Grzybowski A, Pieczynski J, Ascaso FJ. Neuronal complications of intravitreal silicone oil. An updated review. Acta Ophthalmol. 2014;92:201-204. 3. Grzybowski A, Ascaso FJ. Migration of intraocular silicone oil to CNS: the role of elevated intraocular pressure and congenital optic nerve abnormalities. Clin Neuroradiol. 2016;26:127. 4. Ascaso FJ, Grzybowski A. Subarachnoidal migration of intraocular silicone oil. Acta Neurochir (Wien). 2017;159:807.
105: 1006, SEPTEMBER 2017 WORLD NEUROSURGERY
