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S. Kanda; Nasal Visual Field Defects After Macular Hole Surgery With Indocyanine Green (ICG)-Assisted Internal Limiting Membrane (ILM) Peeling . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4044.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report cases with nasal visual filed defects following macular hole surgery with ICG-assisted ILM peeling. Methods: Retrospective, noncomparative case review. Charts of patients with idiopathic macular holes undergoing vitrectomy between January, 2001 and December, 2001 were reviewed. Nineteen eyes of 19 consecutive patients were enrolled in this study. In 12 eyes, ICG solution (0.5%, 0.6 to 0.8 ml) was instilled into the posterior vitreous cavity over the macula and left in place for 3 minutes to assist in the visualization of the ILM. Visual field, best-corrected visual acuity and fundus photography were evaluated. Results: Postoperatively, all patients that underwent vitrectomy with ICG-assisted ILM peeling had visual field defects. Visual field defects included 10 eyes (84%) with nasal defects, 1 (8%) with a temporal defect, and 1 (8%) with an extensive visual field defect. Ophthalmoscopy revealed optic disc pallor in 8 eyes (67%). Seven patients without ICG-assisted ILM peeling showed normal visual field postoperatively, except 1 patient showing an inferotemporal defect. Conclusions: ICG dye may be associated with postoperative nasal visual field defects. The possible mechanisms for the defects include direct toxicity of the ICG dye to the sensory retina through the stained ILM. Although further studies are needed, our results suggest great caution in the use of ICG dye in macular surgery.
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