Toxic posterior segment syndrome caused by silicone oil tamponade resulting in postsurgical retinal vascular occlusion: a case report.

Purpose: We aimed to report a rare case of postoperative retinal vessel occlusion caused by silicone oil. Observations: A 71-year-old male patient presented with decreased visual acuity and was diagnosed with macular hole retinal detachment (MHRD). The patient underwent pars plana vitrectomy (PPV) and was administered a silicone oil injection. The day after surgery, although inflammation and hyperemia within the anterior chamber were mild, fundus examination revealed evidence of retinal blood vessel occlusion. The patient was assumed to have contracted bacterial endophthalmitis and underwent PPV again, wherein the silicone oil was removed followed by antibiotic administration and steroid eye drops initiation. The inflammation improved 2 weeks after surgery; the patient underwent a second operation for MHRD and was administered a silicone oil injection. However, the same vascular occlusion findings were observed the day after surgery. Vascular occlusion was thought to be due to sterile inflammation rather than bacterial endophthalmitis; the inflammatory findings subsided after silicone oil removal. Conclusions: In cases of retinal vascular occlusion occurring early after silicone oil injection, if the anterior segment inflammation is mild, the possibility of toxic posterior segment syndrome must be considered.