Subretinal Brilliant Blue G migration during internal limiting membrane peeling

Maia, Maurício; Farah, Michel Eid; Rodrigues, Eduardo B.; Malerbi, Fernando Korn

doi:10.1136/bjo.2008.151597

Cited by 27 publications

(7 citation statements)

References 6 publications

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“…Likewise, Remy et al [12] concluded that BBG is non-toxic to the human and rat retina. RPE atrophy following accidental subretinal injection of BBG has been reported [14], but the mechanism of damage is unclear: The atrophy could be from mechanical trauma caused by the jet stream of the injection or from retinotoxicity. Ueno et al [15] injected rabbits with BBG subretinally, and found no apoptotic or toxic effects on retinal structure, whereas high concentrations of intravitreal BBG caused vacuolization of inner retinal cells but left the ERG responses unaffected [10].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

Ejstrup

Cour

Heegaard

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

“…Accidental subretinal delivery of BBG has been reported to cause RPE changes [14] and may cause loss of vision, though subretinal BBG in rats appear safe [15].…”

Section: Introductionmentioning

confidence: 99%

Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

Ejstrup

Cour

Heegaard

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…However, we recently demonstrated that subretinal migration of the dye may cause atrophic changes of the retinal pigment epithelium, and therefore, we strongly suggest avoidance of BBG exposure of the RPE during chromovitrectomy [21]. Additional reports have shown some signs of retinal harming after BBG-assisted ILM peeling.…”

Section: Discussionmentioning

confidence: 99%

Staining Properties of Brilliant Blue Depending on Different Incubation Times and Solvents in Humans

Rodrigues¹,

Maia²,

Penha³

et al. 2013

Ophthalmologica

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Purpose: Intravitreous injection of vital dyes, e.g. brilliant blue (BBG), promotes better visualization of the internal limiting membrane (ILM). This paper investigates the staining properties of BBG depending on different incubation times and 2 types of solvents - 5% glucose (GL) or saline solution - in a prospective study in patients. Methods: This paper investigates various aspects of BBG in various methods. An interventional prospective study was conducted in patients to examine the binding properties of the blue dye diluted in either saline or 5% GL to epiretinal membranes (ERMs) and ILMs. Forty-nine consecutive patients older than 18 years scheduled for macular ERM, vitreomacular traction and macular hole surgeries were prospectively recruited. The primary outcomes of this study were the degree of ILM and ERM staining. The secondary outcomes of the study were the need of reinjection of BBG or any other dye, the ability of BBG to stain the vitreous, and frequency of complications. The staining of the ILM and ERM were graded as no staining, little, moderate or strong staining. Results: There was no correlation between age (p = 0.32) or gender (p = 0.33) in the staining affinity of BBG to either the ILM or ERM. BBG may be an appropriate staining agent for the ILM in the majority (82%) of surgeries; however, in approximately half of the cases (45%) surgeons considered BBG not enough for ERM coloring and visualization. There is a tendency of BBG to stain the ILM better when saline solution is used compared to GL 5%; however, this was not statistically significant (p = 0.64). There was no difference in the staining efficacy of BBG to the ERMs by either solution (p = 0.70), despite the low staining affinity. Conclusion: BBG became the state-of-the-art dye for ILM identification. Differences in staining properties may imply that BBG should not be considered as first-line stain for ERM surgery. BBG is effective in ILM staining in over 80% of macular hole surgeries.

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“…This presentation of the dye was shown to provide a good staining capacity to the ILM and was not toxic in experimental studies and case series in humans [17]. However, BriB could induce RPE changes after accidental subretinal dye injection in humans [18-20]. …”

Section: Introductionmentioning

confidence: 99%

Effect of Vital Dyes on Retinal Pigmented Epithelial Cell Viability and Apoptosis: Implications for Chromovitrectomy

et al. 2013

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Purpose: To investigate the in vitro effect of vital dyes on toxicity and apoptosis in a human retinal pigment epithelial cell line. Methods: ARPE-19 cells were exposed to brilliant blue (BBG), Evans Blue (EB), bromophenol blue (BroB), indocyanine green (ICG), infracyanine green (IfCG), light green (LG), fast green (FG), indigo carmine (IC) and Congo red (CR). Balanced salt solution was used as the control. Five different concentrations and 2 exposure times were tested. Cell viability was determined by the MTS (1-solution methyl thiazolyl tetrazolium) assay and apoptosis by Bax expression on Western blot. Results: All dyes significantly reduced cell viability after 3 min of exposure at all concentrations (p < 0.01), except for BBG that was safe at concentrations up to 0.25 mg/ml and CR up to 0.05 mg/ml, while LG was safe at all concentrations. Toxicity was higher after 30 min of exposure. Expression of Bax was upregulated after all dye exposures, except BBG; ICG had the highest Bax expression (p < 0.01). Conclusions: Overall the safest dye was BBG followed by LG, IfCG, FG, CR, IC, BroB, EB and ICG. ICG was toxic at all concentrations and exposure times tested. Moreover, BBG was the only dye that did not induce apoptosis in ARPE-19 cells.

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Subretinal Brilliant Blue G migration during internal limiting membrane peeling

Cited by 27 publications

References 6 publications

Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

Staining Properties of Brilliant Blue Depending on Different Incubation Times and Solvents in Humans

Effect of Vital Dyes on Retinal Pigmented Epithelial Cell Viability and Apoptosis: Implications for Chromovitrectomy

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