This patient with involuted proliferative diabetic retinopathy received prior intravitreal Avastin injections for diabetic macular edema.
On routine examination, a few asymptomatic silicone oil bubbles were suspended in the superior vitreous.
Fluorescein angiography best shows how these bubbles distort and minify the underlying retinal detail.
Learning Points:
The insulin syringe needles provided by compounding pharmacies for Avastin injections are lubricated with silicone.
Many eyes receiving ongoing intravitreal Avastin developed these vitreous silicone droplets, most of which were completely asymptomatic.
Once knowledge of these silicone droplets became available, use of these insulin syringes was discontinued.
