Comparison of ICG-assisted ILM peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic macular oedema

Bardak, Yavuz; Çekıç, Osman; Tiğ, Şahin

doi:10.1038/sj.eye.6702152

Cited by 32 publications

(19 citation statements)

References 11 publications

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“…There are three reports of ICG use in patients undergoing surgery for diabetic macular oedema. Two showed a favourable safety profile, 44,45 whereas one showed visual field defects, 42 making it difficult to draw a conclusion.…”

Section: Surgery For Diabetic Macular Oedemamentioning

confidence: 99%

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

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Indocyanine green (ICG) is extremely effective when used as a vital stain during macular hole surgery. By staining the internal limiting membrane, ICG facilitates removal of this delicate and sometimes hard to visualize structure. There is, however, considerable debate regarding its safety. This review considers the clinical and experimental studies of ICG and a related agent, infracyanine green. Some clinical papers show visual field defects, reduced visual acuity, and persistence of ICG at the macula and optic nerve. Other clinical studies fail to demonstrate toxicity. The experimental studies are also conflicting, but there are emerging trends. These suggest that surgeons who continue to use ICG should use concentrations not greater than 0.05 mg/ml, in fluid-filled eyes, with short exposure times, iso-osmolar solutions, and avoid proximal or prolonged endoillumination of stained tissue. A smaller number of studies suggest that infracyanine green produces similar staining to ICG, and may possibly be safer, but there are too few well-designed studies to reach a conclusion. Although the use of ICG continues, on the balance of evidence, this review suggests that it is has the potential to produce subtle visual damage.

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Section: Surgery For Diabetic Macular Oedemamentioning

confidence: 99%

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Stanescu-Segall

Jackson

2008

Eye

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“…In an exponentially increasing number of case series studies and nonrandomized comparative studies, IVTA has been used for the treatment of BRVO [80,81,82,83,84,85,86,87,88,89,90,91,92,251]. Özkiris et al [86] evaluated the efficacy of IVTA injection on persistent macular edema in BRVO that failed to respond to previous laser photocoagulation.…”

Section: Clinical Studies: Ta As Drug Treatment For Macular Edemamentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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Background: To provide an update on the intravitreal use of triamcinolone acetonide. Methods: Review of literature regarding triamcinolone-related research. Results: After the introduction of bevacizumab and ranibizumab into clinical practice, intravitreal triamcinolone has lost its leading position as the drug most often injected intravitreally. Due to its properties as a long-acting steroid, triamcinolone has still been used for various conditions such as diffuse diabetic macular edema, retinal vein occlusions, pseudophakic cystoid macular edema, chronic prephthisical ocular hypotony and uveitis, and in combination with bevacizumab or ranibizumab. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataract and postoperative infectious or noninfectious endophthalmitis. Conclusions: Due to its widespread biological effects as a steroid and due to a relatively large therapeutic window, intravitreal triamcinolone has remained in clinical use for a variety of intraocular disorders, and it may be a promising candidate for intravitreal medical combination therapies.

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“…The removal of the ILM during macular surgery in elderly patients is generally done to enhance the surgical outcome. 15,16,20 Removal of the ILM was expected to reduce the recurrence rates by limiting the myofibroblasts proliferation, consequently minimizing the development of a recurrent ERM. Researches have also demonstrated that the surgical outcome is better and ERM recurrence is significantly lower in elderly ERM patients undergoing ILM peeling compared with those without ILM peeling.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome after removal of idiopathic macular epiretinal membrane in young patients

Fang

Chen

Weng

et al. 2007

Eye

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Purpose To report the clinical features of the eye of young patients with an idiopathic macular epiretinal membrane (ERM), and the visual outcomes after the surgical removal of the ERM. Methods A retrospective review of the medical records of eight young patients (age, 23-39 years; mean, 32.5 years) with an idiopathic macular ERM was performed. The patients underwent vitrectomy and removal of the ERM with peeling of the internal limiting membrane (ILM). The pre-and postoperative visual acuity and intra-and postoperative complications were investigated. Results Ophthalmoscopically, the ERMs in seven eyes were white, opaque, and dense, while one was grayish-white and less dense. A posterior vitreous detachment was not present and the ERM adhered strongly to the underlying retina in all eight eyes. The mean best-corrected visual acuity (BCVA) preoperatively was 20/140 (Snellen; range: 20/250-20/63), and the BCVA improved significantly to 20/30 (range: 20/40-20/20) postoperatively with an average follow-up of 14.6 months (range: 6-42 months; Wilcoxon sign-rank test, Po0.001). An improvement of 47 lines was observed in seven of eight eyes. A recurrence of an ERM without involving the macula was detected in one eye (12.5%). Conclusions The clinical features of the ERMs in young patients are different from those in elderly patients, eg, thicker, more adherent to the retina, and still attached to the vitreous. Vitrectomy and removal of ERM with ILM peeling are effective and safe surgical procedures. Removal of the ILM may minimize the recurrence of an ERM.

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Comparison of ICG-assisted ILM peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic macular oedema

Cited by 32 publications

References 11 publications

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Vital staining with indocyanine green: a review of the clinical and experimental studies relating to safety

Intravitreal Triamcinolone

Surgical outcome after removal of idiopathic macular epiretinal membrane in young patients

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