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Matthew Starr, Kapil G Kapoor, Sophie J Bakri, Raymond Iezzi, Andrew Barkmeier; Visual Outcomes Using Different Concentrations of Indocyanine Green Following Idiopathic Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1099.
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© ARVO (1962-2015); The Authors (2016-present)
To identify the differences, if any, in visual acuity (VA) using different concentrations of indocyanine green (ICG) dye during macular hole (MH) repair.
We performed a retrospective consecutive review of all idiopathic MH surgeries by three surgeons at Mayo Clinic between March 2009 through February 2012. The main outcome measures were anatomic characteristics and functional outcomes, including VA (measured using logMAR), MH closure rates, and development of serous subfoveal retinal detachment (SSRD). The main variable affecting outcomes that was tracked was ICG dye concentration (0.08mg/ml in D5W = ICG8 vs. 0.41 mg/ml in BSS = ICG41). Two surgeons used the same ICG concentration, 0.08mg/ml in D5W and one used an ICG concentration of 0.41 mg/ml in BSS, applied under air.
118 idiopathic MH surgeries were performed in 118 eyes of 116 patients. Overall macular hole closure rate was 99.2% (117/118) with one surgery and 100% after two surgeries. 44 eyes underwent macular hole repair using the ICG41 while 74 eyes used the ICG8. 4 out of the 44 eyes using ICG41 developed SSRDs (9.01%) while 9 out of the 74 eyes using ICG8 developed SSRDs (12.2%). The mean pre-operative and postoperative VAs for the ICDG8 group were .626 and .203, respectively (Snellen 20/85, 20/33). The mean pre-operative and postoperative VAs for the ICDG41 group were .719 and .438, respectively (Snellen 20/105, 20/55). The mean change in VA after surgery in the ICG8 eyes was .413 (STDEV .252). The mean change in VA after surgery in the ICG41 eyes was .325 (STDEV .347). There was no statistical difference in the improvement in VA following MH repair surgery using two different concentrations of ICG (p value 0.1275).
ICG has been studied extensively for its potential retinal toxicity, mostly stemming from conflicting reports of clinical outcomes. Although most reports suggest good functional outcomes with ICG use, some have reported decreased visual acuity and/or visual field defects. Still, the toxic effect of ICG is still under investigation. In our study, ICG dye was used in two different concentrations and injected under two different conditions. The data of this study suggest that varying ICG dye concentrations do not affect visual outcomes following idiopathic macular hole surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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