J Korean Ophthalmol Soc.  2011 May;52(5):633-638. 10.3341/jkos.2011.52.5.633.

Temporal Hemianopsia of Healthy Eye in a Patient with Contralateral Silicone Oil Filled Eye

• Lee SB
• Shin KS
• Jo YJ

• KMID: 2214586
• DOI: http://doi.org/10.3341/jkos.2011.52.5.633

Abstract

PURPOSE
To report a case of temporal hemianopsia of a healthy eye occurring in the contralateral silicone oil-filled eye due to migration of silicone oil into the optic chiasm and lateral ventricle.
CASE SUMMARY
A 56-year-old man visited our clinic with temporal hemianopsia for 10 days in the left eye. Three months before, the patient had presented with decreased vision and ocular pain in the right eye as well as a headache. The patient underwent vitrectomy at another hospital for the management of retinal detachment occurring in the right eye 8 years earlier. In addition, for recurred retinal detachment, reoperations were performed twice with silicone oil injection. Funduscopy revealed findings such as glaucomatous optic disc and an intraocular pressure of 54 mmHg in the right eye. On visual field examination, the temporal hemianopsia was detected in the left eye. Under the suspicion of cerebral lesions, a magnetic resonance imaging (MRI) examination was performed. On the right side of the optic chiasm and the suprasellar region, materials were present whose signal intensity was identical to silicone oil in the right vitreal cavity. During a follow-up, the migration of silicone oil into the lateral ventricle and the alteration of its location with the positional change were observed.
CONCLUSIONS
In a patient who received silicone oil injection following vitrectomy, the silicone oil migrated to the optic chiasm and induced the occurrence of visual field defect in the contralateral eye. The visual field defect improved because of the migration into the lateral ventricle.

Keyword

Glaucoma; Migration; Silicone oil; Visual field defect

MeSH Terms

Eye
Follow-Up Studies
Glaucoma
Headache
Hemianopsia
Humans
Intraocular Pressure
Lateral Ventricles
Magnetic Resonance Imaging
Middle Aged
Optic Chiasm
Retinal Detachment
Silicone Oils
Vision, Ocular
Visual Fields
Vitrectomy
Silicone Oils

Figure

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  Figure 1. Color fundus photograph shows elevated retina and the cup-disc ratio is 1.0 in the right eye. There is the reflex on the retinal surface by the silicone oil. There were no abnormal findings in the left eye.

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  Figure 2. (A) Left temporal hemianopia of the left eye. Visual acuity was 1.0. (B) 1 month later, after migration of silicone oil into lateral ventricle, the visual field defect improved.

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  Figure 3. (A) Computed tomography (CT) of the head shows 1.4 cm sized no enhanced mass in the suprasellar area (arrow). (B) There was no mass in the ventricle. (C) A axial T2-weighted magnetic resonance imaging (MRI) scan of the head shows hetero-genous signal intensity in the silicone filled right eye as well as in the right side of the optic chiasm (arrow).

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  Figure 4. (A) Computed tomography (CT) scan of the head, about 1 cm sized hyperdense mass is newly seen in the left lateral ventricle. The material filling the right eyeball, suprasellar area and the new lesion in the frontal horn of the left lateral ventricle showed identical CT density (arrow). (B) T2-weighted magnetic resonance imaging (MRI) scan shows a new lesion (arrow). (C) Computed tomography (CT) scan of the head, axial section, with the patient in a prone position. Silicone oil shifts to the posterior portion of the lateral ventricle (arrow).

Reference

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