Abstract
Abstract: :
Purpose: Indocyanine green (ICG) can be injected in the vitreous cavity after vitrectomy to stain the internal limiting membrane (ILM). This staining facilitates the peeling of the ILM in the macular area. Toxicity of ICG has been described. Persistant staining of the disc has recently been published (R. Spaide, Retina 2002). The purpose of our study is to evaluate the long term infrared fluorescence of the macula and the optic nerve after vitrectomy and staining with ICG of the ILM in cases of macular diseases. Methods: A consecutive series of 19 eyes of 18 patients with macular hole (14), branch vein occlusion (3 eyes), macular edema (1 eye) and macular pucker (1 eye) was studied in a prospective manner. During surgery, after vitrectomy, 0.1cc of ICG (Infracyanine® SERB) was injected over the posterior pole, left in place during 1 minute and removed. The ILM was then easily removed from the macular area. After surgery, digital fundus infrared photographs were taken with the excitation and blocking filters used for ICG angiography during follow up. Results: Mean follow up was 10,6 months (2,6 – 18,4 months). We observed infrared fluorescence of the macula in 14 eyes, of the optic nerve in 17 eyes. Of the 10 eyes with at least 1 year follow up, 8 demonstrated a less intense but persistent infrared fluorescence of the optic nerve, and 6 an infrared fluorescence of the macula. No other change was observed in the fundus, that could be related to a possible toxic effect of the dye. Conclusions: ICG staining facilitates the removal of the ILM but persistant infrared fluorescence of the macula and the optic nerve can be observed over 1 year after surgery. The safety of ICG has to be confirmed by further studies.
Keywords: vitreoretinal surgery • macular holes