Recovery of visual field and acuity after removal of epiretinal and inner limiting membranes

Garweg, Justus G.; Bergstein, Daniel; Windisch, B. K.; Koerner, Frederick C.; Halberstadt, Markus

doi:10.1136/bjo.2007.131862

Cited by 18 publications

(8 citation statements)

References 36 publications

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“…This compared the visual outcome in 29 patients undergoing the removal of the ILM or epiretinal membranes with infracyanine green to 14 patients in whom trypan blue was used instead. 107 Compared to the preoperative status, only the trypan blue group showed a significant improvement in acuity, with no reduction in the central visual field. In contrast, the infracyanine group showed a Summary: histological studies 1 Light and electron microscopy and immunohistochemistry have been used to study excised surgical specimens and cadaver eyes exposed to ICG 2 ICG may alter the cleavage plane, with deeper retinal elements adherent to the peeled ILM 3 ICG combined with long wavelength light (4620 nm) may increase cell damage 4 The relevance of cadaver eyes to the in vivo use of ICG is not known 5 It is not certain that all the changes observed in surgical specimens were caused by ICG ICG safety D Stanescu-Segall and TL Jackson…”

Section: Clinical Studiesmentioning

confidence: 83%

“…[96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111] Despite the presence of various cell types in excised specimens, no clinical evidence of dye-related toxicity was reported in a study by Ullern et al 102 The specimens removed in macular hole surgery disclosed that few cells, were very thin, and were scarcely positive for vimentin using immunohistochemistry, suggesting that the surgical cleavage plane was not altered. 103 …”

Section: Experimental Studiesmentioning

confidence: 99%

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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: Clinical Studiesmentioning

confidence: 83%

Section: Experimental Studiesmentioning

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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“…87 In a direct prospective, non-randomized comparison of IFCG and TB-assisted peeling of the ILM, TB had better central visual field results. 51 In contrast, a prospective, randomized study, investigating a larger number of patients, found no difference in visual field or visual acuity outcomes between ICG-and TB-assisted ILM peeling in macular holes. 88 These two studies provide the best quality evidence comparing TB with other dyes.…”

Section: Trypan Bluementioning

confidence: 92%

“…Finally, infracyanine green (IFCG), a biosimilar dye to ICG, was briefly investigated as an alternative to ICG and was hypothesized to have an improved safety profile due to a more physiological osmolarity as well as a lack of iodine. [48][49][50][51][52] After several published investigations, alternate dyes such as trypan blue and brilliant blue G gained more investigative enthusiasm and IFCG is not routinely used. The number of adverse events reported with BBG is fewer than with ICG.…”

Section: Historical Perspective: Introduction Of Icg-assisted Ilm Peementioning

confidence: 99%

Vital Dyes in Vitreomacular Surgery

Bracha¹,

Ciulla²,

Baumal³

2018

Ophthalmic Surg Lasers Imaging Retina

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Vital dyes contain complex molecules with chromophores that stain living tissues and have greatly enhanced identification and removal of transparent vitreoretinal tissues during surgery. Several "chromovitrectomy" dyes are frequently used by vitreoretinal specialists, including indocyanine green, trypan blue, brilliant blue G and triamcinolone acetonide; other dyes are also under investigation. Currently available chromovitrectomy dyes have their limitations, and of particular concern is their possibility for acute and chronic toxicity to the neurosensory retina and retinal pigmented epithelium. The potentially irreversible acute toxicity and other limitations, such as lack of long-term safety profiles, highlight the need for a review of the current literature and for further advancements.

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“…Since then, it has greatly evolved due to advances in instrumentation, the use of dyes to identify the ERM and the internal limiting membrane (ILM), and the development of sutureless and smaller-gauge vitrectomy technology. Most series of PPV for the removal of ERM report high rates of visual recovery and low rates of complications [2,7,8,9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Outcomes of Epiretinal Membrane Removal in Eyes with and without Concurrent Vision-Limiting Ocular Disease

Moisseiev

Davidovitch²,

Loewenstein³

et al. 2011

Ophthalmologica

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Purpose: To evaluate preoperative and intraoperative parameters in patients who underwent pars plana vitrectomy (PPV) for epiretinal membrane (ERM) removal and identify prognostic factors for visual recovery and complications. Furthermore, eyes with and without additional vision-limiting ocular disease were compared. Methods: Ninety eyes of 90 patients who underwent PPV and ERM peeling were included in this retrospective study. Patients were divided according to the presence of additional vision-limiting conditions. Results: The mean visual acuity (VA) improvement was –0.156 logMAR. No parameter was found to correlate with the final VA or postoperative complications. Thirty-four patients (37.8%) had concurrent vision-limiting ocular conditions. Although these eyes had lower initial and final VA, there was no significant difference in VA improvement between them and eyes without concurrent disease. Conclusions: PPV and membrane peeling is an effective treatment for patients with ERM, even in the presence of concurrent vision-limiting ocular disease.

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Recovery of visual field and acuity after removal of epiretinal and inner limiting membranes

Cited by 18 publications

References 36 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

Vital Dyes in Vitreomacular Surgery

Outcomes of Epiretinal Membrane Removal in Eyes with and without Concurrent Vision-Limiting Ocular Disease

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