Evaluation of Retinal Toxicity by ERG Before and After Pars Plana Vitrectomy in ILM Peeling Assisted by Brilliant Blue G Staining at a Concentration of 1 mg/ml. Pilot Study

Abstract

Purpose: : To evaluate, with standard electroretinogram (ERG),in vivo retinal toxicity after surgical application of Brilliant Blue G using a 1mg/ml concentrationMaterial and

Methods: : Eight patients underwent phacoemulsification with IOL implantation and pars plana vitrectomy with peeling of the internal limiting membrane (ILM) assisted with 1mg/ml concentration of Brilliant Blue G. Gas tamponade with SF6 was used in all cases. Best corrected visual acuity (BCVA) measurement and ERG were performed prior to surgery and one month afterwards. Macular hole architecture and closure were evaluated clinically and by spectral domain optical coherence tomography (SD-OCT).

Results: : Six females and two males were enrolled in the study with a mean age of 68.5 ±7.8 years. A sufficient staining of the ILM was seen in all cases and peeling was successfully achieved. BCVA improved from one to six lines. Clinical observation showed closure of all macular holes and was confirmed by SD-OCT. B-wave amplitude on mesopic ERG was 354.25 ±123.15 µV preoperatively and 305.1±104.19 µV postoperatively (p=0.56). Implicit time on mesopic ERG was 23.36±11.68 msec preoperatively and 12.98 ±6.49 msec postoperatively (p=0.77).

Conclusions: : Using a concentration of 1mg/ml of Brilliant Blue G in macualar hole surgery for staining the ILM seems to have no retinal toxicity detected by standard ERG and the same visual outcome as previously reported. More patients and further studies are needed.

Keywords: electroretinography: clinical • vitreoretinal surgery • retina