Intravitreal Silicone Oil Bubbles After Intravitreal Bevacizumab Injection

Intravitreal Silicone Oil Bubbles After Intravitreal Bevacizumab InjectionAuthor: SaadetGültekin IrgatCo-authors: AlpaslanKoc, Emine cakar, Fatih OzcuraAbstractIntravitreal Silicone Oil Bubbles After Intravitreal Bevacizumab InjectionPurpose: To present the developing intravitreal silicone oil bubles at thethird dose of intravitreal bevacizumab (avastin) therapy for neovascularage-related macular degeneration.Case Report: The case report with fundus photography and biomicroscopeexamination.Results: Intravitreal bevacizumab treatment was planned for a 75-year-oldfemale patient with the diagnosis of neovascular age-related maculardegeneration. The patient's visual level before treatment was 0.05 (snellen),intraocular pressure was 14 mm Hg, and central macular thickness was 527microns. Bevacizumab was prepared under operating room conditions by injectinga single dose of 1.25 mg/0.05 ml into 30-gauge insulin syringes 30 minutesbefore the procedure. Although the patient did not have any complaints afterthe first two doses, two days after the third dose injection, the patientapplied to our clinic in panic because of decreased vision and flying objectsin his eye. On examination, the patient's vision was 0.05. Numerous droplets ofsilicone oil were observed in the vitreous in dilated funsus examination(Figure 1). Although the patient's complaints decreased in the first monthfollow-up, they continued. There was no decrease in the amount of siliconedroplets in the fundus examination (Figure 2). The source is thought to bepolydimethylsiloxane, a lubricant used to reduce friction between the syringebarrel and the plunger and allow the plunger to move smoothly within thechamber. Toxic reactions such as high intraocular pressure and corneal edemadue to silicone oil droplets were not observed in this process.Conclusion: Silicone oil droplets may occur in the vitreous cavity afterintravitreal drug injections. The likely source of silicone oil is the needlesand syringes used for the injections. Silicone droplets should be kept in mindin patients presenting with the complaint of floater after intravitrealinjection.Key Words: intravitreal injection, bevacizumab, silicone oil, floaterFinancial Disclosure No have financial relation