Supplementary Material for: Visualization and Identification of Silicone Oil Emulsification Using Dynamic Infrared Confocal Scanning Laser Ophthalmoscopy

Silicone oil (SO) plays a key-role as an intraocular tamponade in managing complex vitreoretinal diseases. However, its emulsification can lead to severe irreversible anterior and posterior segment complications. Traditional imaging often struggles to visualize SO, necessitating advanced techniques. This study aimed to introduce and evaluate the use of dynamic infrared confocal scanning laser ophthalmoscopy (IRcSLO) in imaging SO and its emulsification. Two patients, post pars plana vitrectomy with SO injection for retinal detachment, were imaged and recorded using the Heidelberg Retina Tomography Spectralis IRcSLO, focusing on the visualization of SO status and emulsified droplets. IRcSLO imaging technique effectively visualized emulsified SO droplets, even in cases where SO was removed. The droplets were identified as micron-sized, spherical entities, with non-uniform distribution. Case presentations highlighted the variability in SO emulsification patterns and the technique's ability to detect even tiny, emulsified droplets. Therefore, dynamic IRcSLO emerges as a potent imaging modality for SO emulsification visualization. It offers insights into droplet count, motility, and localization within the vitreous cavity. This technique holds promise for future studies focusing on emulsification timing, contributing factors, and potential preventive measures. It also offers a deeper understanding of emulsified SO droplet dynamics across different SO viscosities.