Ocular toxicity study of trypan blue injected into the vitreous cavity of rabbit eyes

Veckeneer, Marc; Overdam, Koen A van; Monzer, Jan; Kobuch, Karin; Marle, Wilfried Van; Spekreijse, H.; Meurs, Jan van

doi:10.1007/s004170100341

Cited by 149 publications

(90 citation statements)

References 7 publications

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“…[13][14][15] The safety of intravitreal application of Tb has also been demonstrated in rabbit studies. 16 Recently, Tb has been shown to be a useful intraoperative agent for improving the visualisation and complete removal of peripheral ERM in patients with proliferative vitreoretinopathy. 17 Tb has also been suggested to be useful in staining macular ERM and internal limiting membrane (ILM) in cases of macular hole and macular pucker.…”

Section: Introductionmentioning

confidence: 99%

Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies

Kwok

Lai

et al. 2004

Eye

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Purpose To evaluate the clinical outcome and electron microscopic findings of trypan blue (Tb) and indocyanine green (ICG) assisted epiretinal membrane (ERM) surgery. Methods This is a prospective consecutive noncomparative interventional case series. After pars plana vitrectomy, 0.1 ml of 0.6 mg/ml Tb solution was applied for 1 min under air for ERM staining. After ERM removal, internal limiting membrane (ILM) was further peeled after staining with 0.2 ml of 1 mg/ml ICG solution. Intraoperative specimens were sent for electron microscopy. Tb was considered useful if the edge of ERM was stained where peeling could be initiated with a clearer visualisation of the overall extent of the ERM. Results In all, 16 eyes from 16 patients were recruited. There were nine grade 1 ERMs, five grade 2 ERMs, and two grade 3 ERMs. Tb was useful in six (67%) of the nine eyes with grade 1 ERMs and in all eyes with grade 2 or 3 ERMs. The three remaining grade 1 ERMs were removed together with surrounding ILM that was stained by ICG. The mean line of improvement was 1.3 lines with the median BCVA improved from 6/12 to 6/9. All 16 eyes had symptomatic improvement and none developed ERM recurrence. No complication related to Tb or ICG was observed clinically or angiographically. Electron microscopy of the Tb-stained ERM specimens showed fragments of ILM in all specimens. Conclusions Tb and ICG are useful intraoperatively to improve the visualisation and facilitate complete removal of ERM and ILM in macular ERM surgery.

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Section: Introductionmentioning

confidence: 99%

Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies

Kwok

Lai

et al. 2004

Eye

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“…5,6 It can be argued that the loss in VA of some of the patients was potentially due to dye toxicity. However, Veekeneer et al, 8 investigating toxicity of Trypan blue at various concentrations (0.2 and 0.06%) found that only at 0.2% did Trypan blue show any signs of toxicity, manifest as damaged photoreceptors and marked disorganization with light and electron microscopy and reduced immunohistochemical staining for rhodopsin. At 0.06% concentration of Trypan blue (the concentration of Trypan blue available as VB) was concluded to be harmless.…”

Section: Discussionmentioning

confidence: 99%

Trans-scleral dye injection during vitreous surgery to identify clinically undetectable retinal breaks causing retinal detachment

Gupta

Ong

Burton

2011

Eye

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Background/aims Finding all retinal breaks is a critical step in rhegmatogenous retinal detachment (RRD) surgery in order to prevent persistent/recurrent retinal detachment (RD). We describe a technique of trans-scleral dye injection into the subretinal fluid under the detached retina in the context of recurrent/ persistent RD in vitrectomized eyes, in order to determine the location of clinically unidentified (occult) retinal breaks causing RD. Methods Retrospective consecutive single-surgeon case-series analysis of patients presenting with a repeat RRD after having been treated with pars plana vitrectomy (PPV) as the method of primary RRD repair. Trans-scleral injection of subretinal vision blue (TSVB) was used to help identify retinal breaks during repeat vitrectomy. Outcome measures: successful detection of a break; location of breaks; persistent retinal attachment; final visual acuity (VA); complications. Results There were 395 cases of RRD during the 3-year period reviewed. TSVB was used for eight instances in seven eyes. All eight instances were repeat RRD. TSVB facilitated occult break detection in 7/8 instances of use. Breaks were at or adjacent to the previous cryo site in three instances. Persistent retinal attachment was achieved in 5/7 cases. Final VA increased in 5/7 cases. There was no evidence of complications as a result of TSVB injection. Conclusions TSVB coupled with indentation to vent a plume of dye through an occult break during vitreous surgery is a relatively simple technique that may facilitate the identification

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“…4 As compared with ICG, Trypan blue appears to have a broader safety profile, as it is non-toxic to cultured retinal pigment epithelial cells and glial cells at concentrations used clinically between 0.06 and 0.2%, and is non-toxic to rabbit retina when it is promptly removed. 18,23,[25][26][27] . Compared with ICG, it is easier to remove from the vitreous cavity, given its high water solubility.…”

Section: Discussionmentioning

confidence: 99%

Use of heavy Trypan blue in macular hole surgery

Oberstein

Smet

2010

Eye

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Purpose Intraocular dyes facilitate the identification of the inner limiting membrane (ILM) during surgery. Appropriate dyes should be safe, provide adequate staining, and be easy to use. Heavy Trypan blue eliminates the need for an air-fluid exchange (AFX) and appears to have little retinal toxicity. This study refers to a prospective, consecutive trial with heavy Trypan blue in macular hole surgery. Patients and methods A consecutive group of 20 patients with full thickness macular holes was recruited in a single institution study. Patients were operated using conventional methods. Heavy Trypan blue was prepared by mixing isovolumetrically glucose 10% with MembraneBlue (DORC, Zuidland, The Netherlands). Patients were assessed for ease of surgery and post-operatively at 3 and 6 months (vision and ocular coherence tomography) for hole closure and vision. Results Twenty eyes were included in the study. Reapplication of dye was used in 75% of the cases, leading to improved contrast further facilitating the ILM peel. In no case was an AFX necessary to obtain sufficient staining. Macular hole closure was achieved in 19 of 20 patients with one surgery. No retinal detachment or other complication was observed in the follow-up period. Conclusion Heavy Trypan blue can be delivered efficiently to the retinal surface without the need for an AFX. Staining was sufficient to help visualise and peel the ILM. Repeat applications were easily performed. The macular hole closure rate was similar to that of other series with a comparable visual improvement.

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Ocular toxicity study of trypan blue injected into the vitreous cavity of rabbit eyes

Cited by 149 publications

References 7 publications

Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies

Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies

Trans-scleral dye injection during vitreous surgery to identify clinically undetectable retinal breaks causing retinal detachment

Use of heavy Trypan blue in macular hole surgery

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