Anatomical and functional changes of retina following subretinal injection of high-speed fluid

Uemoto, Riyo; Nakasato-Sonn, Houmei; Meguro, Akira; Okada, Eiichi; Mizuki, Nobuhisa

doi:10.1007/s00417-011-1800-z

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Nevertheless, we found functional and structural retinal abnormalities during follow-up, including staining on fluorescein angiography and reduced amplitudes and increased implicit times in the macula on mfERG. There are previous reports 8,9 of changes shown on fluorescein angiography and optical coherence tomography (window defects and outer retina damage) in the areas of the retina exposed to subretinal BBG, but there is no definitive evidence that these findings were due to the dye. It is also known that mfERG abnormalities may be present in eyes with ERM and that a further amplitude reduction may be observed in the peeled areas after surgery, even without the use of intraoperative dyes.…”

Section: Discussionmentioning

confidence: 94%

Accidental Subretinal Brilliant Blue G Migration During Internal Limiting Membrane Peeling Surgery

et al. 2015

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rilliant blue G (BBG) selectively stains the internal limiting membrane (ILM), improving visualization during ILM peeling. 1 Despite controversy about the safety profile of the dye, BBG has been widely used intraoperatively in many countries. 1 Accidental delivery of dyes into the subretinal space is a well-known complication associated with macular surgical procedures. 2-5 In this report, we describe the outcomes of retinal function and structure during 2 years in a patient after epiretinal membrane (ERM) and ILM peeling with accidental migration of BBG into the subretinal space at the macular area. Report of a Case A man in his 60s presented with decreased visual acuity and progressive metamorphopsia for 6 months in his right eye. The patient had a history of glaucoma and had been monitored in our clinic for the past 5 years with well-controlled intraocular pressure and stable visual field defects. Examination demonstrated a best-corrected visual acuity (BCVA) of 20/70 OD and 20/20 OS. Intraocular pressure was 13 mm Hg and 12 mm Hg, respectively. Slitlamp examination demonstrated mild nuclear sclerosis in each eye. Dilated ophthalmoscopic examination demonstrated thinning of the neuroretinal rim in each eye and an ERM with vascular tortuosity in the right eye. Optical coherence tomography (Heidelberg retinal angiography; Heidelberg Engineering) of the right eye was notable for an ERM and a central subfield macular thickness (CSMT) of 596 μm (Figure 1). Multifocal electroretinography (mfERG) (Espion E2; Diagnosys LLC) of the right eye revealed amplitude and implicit times within the reference range (Figure 2). Surgical Procedure Phacoemulsifications with posterior chamber intraocular lens (MA60AC +22.5 diopters; Alcon Inc) placement, followed by 23-gauge pars plana vitrectomy (Accurus system; Alcon/ Grieshaber), were performed on the right eye. Three nonvalved trocars (Alcon Inc) were placed, and triamcinolone acetonide, 0.4 mg, in 0.1 mL (Ophthalmos) was used to stain the IMPORTANCE This case report describes a man who developed retinal changes in his right eye associated with brilliant blue G migration into the subretinal space during 2 years of follow-up. OBSERVATION The patient's best-corrected visual acuity in the right eye was 20/70 before surgery, and it improved to 20/25 at 1 year after surgery. Fluorescein angiography showed staining during the late phase in the central macula at all follow-up visits after surgery. Multifocal electroretinography demonstrated normal amplitude and implicit times before surgery but decreased amplitudes and increased implicit times in at least 5 contiguous hexagons after surgery on all 3 examinations performed during the 2-year follow-up period. These functional changes were not topographically correlated with the area of fluorescein staining or with the internal limiting membrane peeled area, but were matched to the area where brilliant blue G accidentally entered the subretinal space. Microperimetry demonstrated reduced retinal threshold sensitivity, particularly in areas...

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Section: Discussionmentioning

confidence: 94%

Accidental Subretinal Brilliant Blue G Migration During Internal Limiting Membrane Peeling Surgery

et al. 2015

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“…Further studies are needed to define if RD leads to such secondary long-term toxicity as suggested by the speed of the subretinal fluid injection. 39 , 40 …”

Section: Discussionmentioning

confidence: 99%

Adaptive Optics Flood Illumination Ophthalmoscopy in Nonhuman Primates

Dentel¹,

Brazhnikova²,

Norberg³

et al. 2023

Ophthalmology Science

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“…To achieve good staining of the ILM, the BBG solution must come in contact with the ILM, however when the conventional BBG solution is injected into the vitreous, it disperses throughout the vitreous cavity (see online supplementary video 1). When the adjuvant is jetted strongly against the ILM, a retinal perforation can occasionally occur (see online supplementary video 2) 2 3…”

Section: Introductionmentioning

confidence: 99%

Staining internal limiting membrane with a mixture of BBG and sodium hyaluronate

et al. 2012

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Anatomical and functional changes of retina following subretinal injection of high-speed fluid

Cited by 4 publications

References 3 publications

Accidental Subretinal Brilliant Blue G Migration During Internal Limiting Membrane Peeling Surgery

Accidental Subretinal Brilliant Blue G Migration During Internal Limiting Membrane Peeling Surgery

Adaptive Optics Flood Illumination Ophthalmoscopy in Nonhuman Primates

Staining internal limiting membrane with a mixture of BBG and sodium hyaluronate

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