Visual outcome and electron microscopic features of indocyanine green-assisted internal limiting membrane peeling from macular hole of various aetiologies

A Comparison of Brilliant Blue G, Trypan Blue, and Indocyanine Green Dyes to Assist Internal Limiting Membrane Peeling During Macular Hole Surgery

“…9 Kumar et al 23 have used 5 mg/mL of ICG dissolved in sterile water like us: They reported improved visual outcomes in 50% eyes in idiopathic MHs and in 80% of eyes in a mixed group, which included myopic and traumatic MHs. 24 Our visual outcomes with ICG were marginally inferior to theirs, probably because we operated only large (Stage 3-4) MHs, reported be the main determinant for poor outcomes in their first study. 23 The other limitations of this study were that it was partly retrospective and had relatively small treatment groups for comparison; BBG and TB were used concurrently, while the experience with ICG dated 10 months to 12 months back.…”

“…Though several studies have reported excellent visual outcomes with 4-mg/mL to 5-mg/mL dilution of ICG and exposure times of 30 seconds to 300 seconds, [19][20][21][22][23][24] most of them added balanced saline or 5% dextrose solutions to reconstitute the dye to avoid hypo-osmolar retinal injury, considered to be as significant as chemical toxicity of ICG dye. 9 Kumar et al 23 have used 5 mg/mL of ICG dissolved in sterile water like us: They reported improved visual outcomes in 50% eyes in idiopathic MHs and in 80% of eyes in a mixed group, which included myopic and traumatic MHs.…”

Comparative evaluation of anatomical and functional outcomes using brilliant blue G versus triamcinolone assisted ILM peeling in macular hole surgery in Indian population

“…The challenge lies in selecting a dye which stains ILM selectively without affecting macular function adversely. Various dyes which have been used for the same purpose include indocyanine green (ICG), trypan blue (TB), triamcinolone acetonide crystals (TA) and the recently introduced brilliant blue G (BBG) dye [18][19][20][21].…”

Tractional Maculopathies in Age-related Macular Degeneration

“…In addition, tangential forces across the gap shown to be related to ERM and newly synthesized collagen fibrils within the cortical vitreous are also involved. [55][56][57] Post-mortem specimens of macular holes often show the presence of subtle pre-and epi-retinal membranes in 30-73 % of cases. 58 This presence is no coincidence and the membranes are thought to evolve from gliotic reactions and to have an essential role in macular hole dynamics.…”

“…In addition, ILM peeling to remove the scaffold for glial and myofibroblast cell migration into the vitreoretinal interface has also been advocated, as many authors have found this to correlate with higher anatomical and functional success in macular hole and ERM surgery, and lower recurrence rates. 57,58,63 To facilitate visualization during surgery, the use of intravitreal vital dyes, such as Trypan blue, triamcinolone acetonide, indocyanine green, and more recently brilliant blue, is encouraged for staining the ERM and ILM. However, the risks of using these dyes in the presence of concomitant tractional maculopathies and AMD are unknown and therefore should be used with caution.…”