Atlas of Ophthalmology

Residual Perfluorodecaline Vesicle in Optic Disc Pit in an Deep Excavated Glaucomatous Optic Nerve Head (Colour Fundus Photography, SD-OCT)

العصب البصري -> حالات جراحية وتالية للجراحة
Patient: 70 years of age, female, BCVA 0.7 at OD, light perception at OS, IOP 12/13 mmHg under Brimonidin and Xalatan. Ocular Medical History: High myopia, primary open angle glaucoma, 20 years ago pars plana vitrectomy at OS. General Medical History: empty Purpose: to show a residual Perfluorodecaline vesicle in an optic disc pit. Methods: colour fundus photography, OCT (HE). Findings: Colour fundus photography: visible residual perfluorodecaline vesicle in an optic disc pit (ODP). The optic disc pit is in the temporal area of the left optic nerve head with an advanced glaucomatous optic nerve atrophy. OCT: showing a residual perfluorodecaline vesicle in an optic disc pit (ODP) of a deep excavated glaucomatous optic nerve head. Discussion: Perfluorodecalin is a perfluorocarbon liquid used intraoperatively in retinal detachment repair. The clarity of perfluorocarbon liquids, with a refractive index is close to that of water. It is usually removed at the end of the procedure. However, residual amounts may be retained. Peyman et al. (1) reported, that perfluorocarbon liquids have been used to facilitate surgery in a wide variety of conditions, including proliferative vitreoretinopathy, giant retinal tears, drainage of suprachoroidal hemorrhages, diabetic traction, retinal detachments with a rhegmatogenous component, dislocated crystalline or intraocular lenses, and retinal detachment associated with choroidal coloboma. All perfluorocarbon liquids when used as tamponading agents can compress and disorganize the retina. This "toxicity" is a physical effect rather than chemical toxicity and depends upon the amount of perfluorocarbon liquid injected. Perfluorocarbon liquids are not tolerated in the anterior chamber, causing corneal edema within 2-3 days at the site of contact. Literature: Peyman GA, Schulman JA, Sullivan B. Perfluorocarbon liquids in ophthalmology. Surv Ophthalmol. 1995 Mar-Apr;39(5):375-95.

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