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Matias Iglicki, jorge zarate, Lucia Comastri, juan cortalezzi, juan pablo francos, Diego A Bar, Carmen N Demetrio, pablo chiaradia, Marcelo Zas; Are the dyes enough for a complete peeling of the ILM or ERM and to distinguish the causes of the ERM ? : histopathological study.Up to Date. . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5057. doi: https://doi.org/.
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To evaluate whether it is necessary to do a histophathological study of the tissues which were peeled off from the epiretinal membrane or macular hole or whether the use of dyes (like Brilliant Blue and Trypan Blue) is enough.Also to realize if using dyes we can identified the causes of the ERM ( primary, secondary or idiopathic)
Fifty different patients with vitreoretinal interface pathologies, such as epiretinal membrane and macular holes, were operated on using the 23G vitrectomy technique in epiretinal membrane surgery. Trypan blue dye was used for staining of the ERM and brilliant blue G dye was used to stain the ILM. The tissue removed during the vitrectomy was sent to the Anatomical Pathology Department to undergo histopathological analysis. The samples were labelled with a code, so as the pathologist would not know which tissue was being analysed. The diagnosis and monitoring of patients were done by means of: symptoms, fluorescein angiography, Optical Coherence Tomography (OCT) and Best Corrected Visual Acuity (BCVA) with ETDRS charts before and after surgery. The patients’ visual acuity prior to surgery was 20/200 and it increased to 20/80 after surgery. Patients were monitored through Visual Acuity and OCT every three months after surgery.
The anatomopathological results indicated that 100% of the sample tissues which were considered to be ILM or ERM were in fact correct.Also the pathologist was able to distinguish the cause of ERM, i.e. primary secondary( inflammatory) or idiopathic
Based on the results thrown by this study, it can be concluded that both, brilliant blue G and Trypan blue, are excellent anatomical markers for the removal of the epiretinal membrane as well as the ILM. In consequence, the histopathological analysis would not be a necessary step.<br /> It can be added that using dyes we can distinguish several cells markers that tell us the cause of the ERM.we can diagnose diseases such as diabetes even before that the patients have any sing or symptom.
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