From Vitreous to Ventricles: Serial Imaging of Intracranial Silicone Oil Migration.

Purpose: To review a case of intracranial silicone oil (SO) migration with mobile intraventricular deposits and analyze serial imaging features over 53 postoperative months. Methods: A single case report and literature review were presented. Results: A 52-year-old man with advanced bilateral proliferative diabetic retinopathy who had placement of 1000 mPa.s viscosity Oxane 1300 SO (Bausch + Lomb) in the right eye presented with sudden loss of consciousness 31 and 53 months postoperatively. Serial computed tomography and magnetic resonance imaging showed progressive intracranial migration of SO with unilateral optic nerve, optic chiasm, bilateral mobile intraventricular deposits, and progressive parenchymal atrophy. Conclusions: Intracranial migration of intravitreal SO is an exceedingly rare complication thought to be associated with suboptimal postoperative intraocular pressure control and anatomic optic disc abnormalities, with variable symptomatology and uncertain clinical significance. Early and complete removal of SO is generally advised, while also maintaining adequate postoperative pressure control in susceptible eyes.