title: Silicone oil in the subarachnoidal space--a possible route to the brain?
abstract: Using this case report, we sought evidence that silicone oil may infiltrate the subarachnoidal space. Vitrectomy combined with silicone oil implantation was performed on the right eye of a 72-year-old woman. The silicone oil was removed 2 months later, because the patient had developed elevated intraocular pressure. The blind and painful eye was subsequently enucleated. By light microscopy, presumed silicone oil bubbles were identified in the optic nerve and the subarachnoidal space of the enucleated eye. These vacuoles were examined by energy-dispersive X-ray analysis (EDAX). In addition, in the vacuoles, immunohistochemistry was used to test for the presence of CD 68-positive macrophages. Silicone oil infiltration sites in the optic nerve, in the central retinal artery, and in the subarachnoidal space were located by light microscopy and confirmed by EDAX. CD 68-positive macrophages were found in the silicone-filled vacuoles. Silicone oil used for endotamponade may infiltrate the optic nerve and even the subarachnoidal space. This supports the assumption that silicone oil, under special circumstances, may even migrate into the brain.
authors.affiliation: 1st Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Tömõ str. M 25-29, Budapest, H-1083, Hungary. pappand@szeml.sote .hu
authors.forename: András
authors.initials: A
authors.lastname: Papp
authors.forename: Jeannette
authors.initials: J
authors.lastname: Tóth
authors.forename: Tibor
authors.initials: T
authors.lastname: Kerényi
authors.forename: Márta
authors.initials: M
authors.lastname: Jäckel
authors.forename: Ildikó
authors.initials: I
authors.lastname: Süveges
mesh_terms: D000368:Aged; D001927:Brain Diseases / Q000209:etiology* / Q000473:pathology; D004577:Electron Probe Microanalysis / Q000379:methods; D015353:Eye Enucleation; D005129:Eye Foreign Bodies / Q000209:etiology* / Q000473:pathology; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D011183:Postoperative Complications / Q000139:chemically induced* / Q000473:pathology; D011859:Radiography; D012827:Silicone Oils / Q000009:adverse effects* / Q000032:analysis; D013346:Subarachnoid Space; D014821:Vitrectomy
chemical_list: D012827:Silicone Oils