Description
A 54-year-old woman presented a year after vitreoretinal surgery with silicone oil injection in the left eye. The left eye showed emulsified silicone oil in the anterior chamber and a posterior chamber intraocular lens. The fundus revealed a posterior staphyloma, attached retina and whitish emulsified silicone bubbles with a horizontal lower border giving rise to inverse hypopyon in the posterior pole (figure 1).
Figure 1.
The fundus photo shows chorioretinal atrophy temporal to the optic disc and emulsified silicone oil bubbles with a horizontal lower level suggestive of inverse hypopyon.
Inverted hypopyon at the posterior pole1 is a rare finding which can be seen in patients with posterior staphyloma and long-term silicone oil tamponade.2 The emulsified silicone oil being lighter than fluid floats superiorly giving rise to this appearance mostly in the anterior segment (hyperoleon).3 In our case, the emulsified silicone oil bubbles (asterisks, figure 2) were limited within a pocket of residual hyaloid/membrane (arrows, figure 2) at the edge of the staphyloma leading to an appearance of an inverted hpopyon in the posterior segment.
Figure 2.
Horizontal optical coherence tomography image (A) and oblique vertical scan (B) revealed a membrane (arrows) with hyperreflective droplets of emulsified silicone oil bubbles (asterisks) trapped between the membrane and the retina.
Learning points.
Inverse hypopyon or hyperoleon is a feature of emulsified silicone oil.
The inverse hypopyon may be seen in the anterior chamber or rarely in the posterior segment.
Footnotes
Contributors: KT managed the patient. Both KT and RC wrote the manuscript, approved the current form and agreed to be accountable for the work.
Competing interests: None declared.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; externally peer reviewed.
References
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