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T. Nuzzo, L. Migliavacca, S. Mattioli, E. Carini, N. Orzalesi; Indocyanine Green Fluorescence After Posterior Vitrectomy for Macular Pucker. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4438.
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To evaluate indocyanine green (ICG) fluorescence and acute toxicity after ICG-assisted peeling of macular pucker.
In a retrospective study 16 consecutive patients (8 males and 8 females, mean age 72), who underwent posterior vitrectomy for macular pucker with 0.5% indocyanine green staining of the internal limiting membrane (group 1) and 18 consecutive patients ( 11 males and 7 females, mean age 76), who underwent posterior vitrectomy for macular pucker without ICG staining (group 2 ) were analyzed. All the patients underwent a complete ophthalmological examination including ETDRS visual acuity (VA), fundus biomicroscopy, dynamic ICG angiography (ICGA) with HRA and OCT (Stratus, Zeiss) at baseline (visit 1), the day next to the surgery (visit 2) and after seven (visit 3), 30 (visit 4), 90 (visit 5) and 180 days (visit 6).
Group 1 showed a central hypofluorescent area corresponding to the area of peeling surrounded by a hyperfluorescence fundus which included the optic nerve, lasting for the entire duration of follow up. No hyperfluorescence was seen in controlaterales eyes. Baseline mean ETDRS VA went from 20/63 to 20/50 for group 1 and from 20/50 to 20/40 for group 2 at visit 6. Mean OCT decrease at visit 6 was 105 µm for group 1 and 115 µm for group 2. The difference in final VA in ICG stained and non-stained patients was not statistically significant (p > 0.05, T-test).
ICG assisted peeling of macular pucker induces long standing hyperfluorescence of optic disc and of the fundus surrounding the peeling area which remains hypofluorescent. Acute toxicity of ICG staining was not apparent in comparison with non ICG stained cases.
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