Background: silicone oil (SO) is used as a vitreous replacement and has been shown to be effective in repairing complicated retinal detachment. Its use, however, may have several disadvantages. Aim: to study the macular changes after SO injection as tamponade in vitrectomy for rhegmatogenous retinal detachment (RRD). Patients and Methods: a prospective, interventional and non-randomized study was performed on 75 eyes (75 patients) of RRD. The patients underwent primary vitrectomy with SO tamponade. All the patients were examined at baseline and postoperatively at day one, one week, one month, and three months. Each visit examination included best corrected visual acuity (BCVA), indirect ophthalmoscopy slit-lamp biomicroscopy, fundus examination by binocular indirect slit-lamp biomicroscopy, measurement of intraocular pressure, and optical coherent tomography (OCT) at 1,3 months postoperatively. Results: 71 of the 75 eyes, had a successful vitrectomy with reattached retina under SO tamponade and 4 eyes were excluded. The patients' mean age was 48±4.5 years. Preoperatively, the macula was on in 41(57.75%) eyes and off in 30(42.25%) while retinal detachment (RD) was total in 18(25.35%) eyes and subtotal in 53(74.65%) eyes. Central macular thickness (CMT) was 177-850 microns. Three months after vitrectomy, CMT was 154-708 microns. While no statistical significant difference was detected between 1 month to 3 months after vitrectomy (P=0.175). Postoperative OCT changes include attenuated IS/OS junction in 16(22.54%) eyes, macular edema in 15(21.13%) eyes, epiretinal membrane in 13(18.31%) eyes. Conclusions: OCT is a beneficial tool for identification of silicone oil maculopathy even in clinically normal maculae.