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M. Horiguchi, N. Horio; Effect of Staining the Internal Limiting Membrane with Indocyanine Green Dye on Visual Function after Idiopathic Macular Hole Surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1975.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the effect of staining the internal limiting membrane (ILM) with indocyanine green (ICG) on the visual function after idiopathic macular hole surgery. Methods: Thirty–one eyes of 30 patients with an idiopathic macular hole (size < 1/2 disc diameter, duration < 12 months) were studied. The concentration, exposure time, and amount of the ICG solution that was minimally required to make the ILM visible were determined. The patients were randomly divided into Group A (16 eyes of 15 patients who underwent ILM peeling without ICG staining), and Group B (15 eyes of 15 patients with ICG staining). Routine examinations were repeated during the 12 months follow–up, and multifocal electroretinogram (mfERG), optical coherence tomography (OCT), and fluorescein angiography (FA) were performed. Results: The macular hole was closed in all patients. The visual acuity was improved in both groups. At 12 months postoperatively, however, the median acuity in Group A was significantly better at 0.85 than in Group B at 0.6 (P <0.05). In addition, the improvement of visual acuity in Group A was significantly better than that in Group B (P<0.05). The mfERG and OCT findings were not significantly different in the 2 groups, and FA showed only weak hyperfluorescence at macular in some patients of both groups. Conclusions: The results suggest that ICG staining should not be used as long as the visibility of the retinal surface is good. However, ICG staining may be acceptable at a low concentration when a clear view of the retinal surface is not present. The results of mfERG, OCT, and FA suggest that the differences in visual recovery was caused not only by pigment epithelial cell damage or retinal toxicity but also probably by the effect of ICG on ganglion cells and their axons.
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