The effect of indocyanine-green on functional outcome of macular pucker surgery

Haritoglou, Christos; Gandorfer, Arnd; Gass, Carolin A; Schaumberger, Markus; Ulbig, Michael W.; Kampik, Anselm

doi:10.1016/s0002-9394(02)01969-4

Cited by 182 publications

(109 citation statements)

References 25 publications

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“…8,9 This is consistent with the subjective findings during this study that the ILM behaved differently and felt 'thicker' during peeling compared to surgery without ICG, suggesting a deeper cleavage plane. Similar damage to the nerve fibre layer may explain the visual field defects reported by Haritoglou et al 8 in 35% of eyes following ICG-assisted ILM peel, compared with no observed field defects in eyes undergoing unassisted ILM peel.…”

Section: Discussionsupporting

confidence: 90%

“…However, other studies have reported small field defects following unassisted ILM peel, 15 and also following macular hole surgery without ILM peel. 1 Other possible causes include dehydration of nerve fibres during air-fluid exchange, 1 trauma to the nerve fibre layer during ILM peel, 8 and trauma to the optic nerve head during induced posterior vitreous detachment.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is a technically demanding procedure, and many surgeons prefer to stain the membrane with indocyanine green (ICG) to provide contrast and facilitate peeling, resulting in high anatomical success rates. [2][3][4][5][6] Recent clinical 7,8 and histopathological [9][10][11] studies have suggested that ICG may be toxic to the retina. We assessed anatomical and functional results of ICG-assisted ILM peel for macular hole and attempted to identify potential factors that may affect the outcome of the procedure through a search of the literature.…”

Section: Introductionmentioning

confidence: 99%

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Visual outcomes following ICG assisted ILM peel for Macular Hole

Posselt

Rahman

Smith

et al. 2004

Eye

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Purpose To evaluate the anatomical and visual outcome of indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling for macular hole surgery. A literature search identified potential factors that may affect the functional success of the procedure. Methods Retrospective case note review of 14 consecutive patients undergoing phacovitrectomy, gas and ICG-assisted ILM peeling for macular hole from July 2001 to July 2002. A 0.5% ICG solution (osmolarity 270 mOsm) was left in contact with the retina for 1-3 min. The outcome measures were hole closure, change in visual acuity, and macular pigmentary changes. Results Anatomical hole closure was achieved in 13 of 14 eyes (92.8%). The mean logMAR Snellen acuities were 0.80 (range 0.60-1.30) preoperatively and 0.77 (0.48-1.30) postoperatively. Seven eyes (50%) developed retinal pigmentary changes in the macular area Conclusions ICG-assisted ILM peeling for macular hole surgery achieves high rates of anatomical hole closure, but functional results are less encouraging. Previous studies suggest toxicity of the ICG to the retina, at the level of the RPE or inner retina. The results may be optimized by using a lower concentration, isoosmolar, viscous solution, and by minimizing contact time of the solution and intensity, and duration of illumination.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Visual outcomes following ICG assisted ILM peel for Macular Hole

Posselt

Rahman

Smith

et al. 2004

Eye

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“…In patients within this age range, there is a wide variety of diseases that affect the inner retina, such as epiretinal membrane, and when amenable to treatment there is the potential for improvement of visual acuity. [42][43][44] In older patients, cataract also degrades visual acuity. Although we did not explore the effect of cataracts, the poor visual acuity in these three patients is unlikely to be explained by cataract, since we required sufficiently clear media to allow good quality FA.…”

Section: Discussionmentioning

confidence: 99%

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Weber

Elsner

Miura

et al. 2006

Eye

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Purpose To investigate the relationship between visual acuity and foveal birefringence in patients with neovascular age-related macular degeneration. Methods In total, 40 patients with choroidal neovascularization underwent macular imaging with scanning laser polarimetry. Bowtie patterns, typically seen in birefringence images of the macula, were evaluated and classified into three categories: (1) regular bowtie present; (2) bowtie present, but disrupted; and (3) no bowtie present. The relation of the bowtie appearance to the best-corrected logMAR visual acuities was tested (ANOVA). Results Mean visual acuity was best for the group that had regular bowties (mean logMAR ¼ 0.34) and differed statistically significantly from the disrupted bowtie group and no bowtie group (P ¼ 0.01 and 0.0007). Ages for the three groups did not differ (P ¼ 0.31). Conclusions Appearance of a regular bowtie indicates a substantially intact Henle fibre layer with the potential for good visual function, despite the presence of underlying pathology. Conversely, disruption or absence of a bowtie may indicate severe damage to the photoreceptors, consistent with the finding of poorer visual acuity.

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“…4 There are also reports on possible retinal damage in humans after macular hole surgery, 5 and ICG staining may even have an adverse effect on functional outcome in macular pucker surgery. 6 An experimental application of ICG to the retina of human donor globes combined with illumination of different wavelengths showed structural changes of the ILM and the inner retina. 7 ICG might be toxic to the RPE and cause damage in the region of the macular hole, where it had Retinal damage after macular hole surgery P Maier et al 538 direct contact with the RPE.…”

Section: Commentmentioning

confidence: 99%