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Ana Claudia B. De Lucca, Felipe P. Almeida, Rodrigo Jorge, Andre Messias; Retinal Function Before and After Pars Plana Vitrectomy in ILM Peeling Assisted by Brilliant Blue G Staining: Assessment with Multifocal ERG (mfERG). Invest. Ophthalmol. Vis. Sci. 2012;53(14):3793.
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To evaluate retinal function using mfERG in eyes with macular hole (MH) or epiretinal membrane (ERM) before and after pars-plana vitrectomy with internal limitant membrane (ILM) peeling assisted by brilliant blue G staining (BBG).
Observational, clinical case series. A total of 34 eyes with MH (n=21) or ERM (n=13) were evaluated with comprehensive ophthalmological examination including ETDRS best-corrected visual acuity (BCVA), mfERG (Diagnosys LLC; 61 hexagons - 30 degrees), and spectral domain optic coherence tomography (sOCT - Heidelberg Engineering), at baseline and 2 months after surgery. Surgery consisted by posterior vitreous detachment assisted with triamcinolone, followed by ERM removal and ILM peeling with (group BBG; n=11) or without (group TAAC; n=23) ILM staining by intravitreal injection of 0.25 mg/mL BBG.
Mean ± SE baseline BCVA (logMAR) was 0.81 ± 0.07 and 0.77 ± 0.06 for BBG and TAAC respectively (P=0.351; t-Test). BCVA outcome was slightly better in BBG group; with mean intra-individual BCVA improvement of 0.41 ± 0.08 logMAR (4 ETDRS lines) and 0.23 ± 0.05 logMAR (2 lines) for BBG and TAAC respectively (P=0.0414; t-Test). mfERG results show focal reduction on central retinal response amplitude at baseline in TAAC and BBG. No significant changes were found for amplitudes or implicit times comparing baseline to results after surgery. Mean intra-individual mfERG amplitude change was: Ring 1 (central): -0.51 ± 3.0, and -1.17 ± 1.26; Ring 2: 1.17 ± 1.30, and -1.15 ± 0.69; Ring 3: 0.97 ± 0.78, and -0.43 ± 0.54, for BBG and TAAC respectively (P> 0.05 in all comparisons). OCT outcome was similar for BBG and TAAC, and no adverse effects were observed during the follow-up period.
mfERG can be used to record retinal function impairment due to MH and ERM. No toxic effects was observed for BBG assisted ILM peeling on mfERG responses. BBG for ILM staining facilitates surgical IML peeling due to better visualization of the membrane, and this data supports its retinal safety.
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