July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Effect of Indocyanine Green Concentration on Subfoveal Hyporeflective Space after Internal Limiting Membrane Peel for Macular Hole Surgery
Author Affiliations & Notes
  • sagar patel
    Ophthalmology, USC, Los Angeles, California, United States
  • Andrew Moshfeghi
    Ophthalmology, USC, Los Angeles, California, United States
  • Ramon Lee
    Ophthalmology, USC, Los Angeles, California, United States
  • Brian K Do
    Ophthalmology, USC, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   sagar patel, None; Andrew Moshfeghi, None; Ramon Lee, None; Brian Do, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5716. doi:
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      sagar patel, Andrew Moshfeghi, Ramon Lee, Brian K Do; Effect of Indocyanine Green Concentration on Subfoveal Hyporeflective Space after Internal Limiting Membrane Peel for Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5716.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Indocyanine green (ICG) staining of internal limiting membrane (ILM) improves visualization, however concerns exist on potential retinal toxicity particularly on the retinal pigment epithelium. This study aims to evaluate the effect of 0.05% ICG compared to 0.03% ICG concentration on significant well-delineated subfoveal hyporeflective space after full-thickness macular hole surgery with ILM peel.

Methods : This study was a prospective cohort from a single surgeon. The control group underwent 0.05% ICG staining and the intervention group underwent 0.03% ICG staining. Inclusion criteria included idiopathic full-thickness macular hole and uncomplicated macular hole surgery. Exclusion criteria included follow-up time less than 30 days. The primary outcome measure included resolution of significant well-delineated subfoveal hyporeflective space on ocular choerence tomography at 1 month. Secondary outcome measures include resolution of subfoveal hyporeflective space at 3 months, best-corrected visual acuity, and time until macular hole closure.

Results : In total, 24 eyes of 21 patients were included. 17 eyes underwent 0.05% ICG staining in the control group and 7 eyes underwent 0.03% ICG staining in the intervention group. At 1 month follow-up, 9 eyes (of 17, 52.9%) in the control group had resolution of subfoveal hyporeflective space compared to 6 eyes (of 7, 85.7%) in the intervention group (p = 0.1317). At 3 month follow-up, 13 eyes (of 17, 76.5%) in the control group had resolution of subfoveal hyporeflective space compared to 7 eyes (of 7, 100%) in the intervention group (p = 0.1598). For full-thickness macular hole closure at 1 month follow-up, 15 eyes (of 17, 88.2%) in the control group had macular hole closure compared to 7 eyes (of 7, 100%) in the intervention group (p = 0.3432). Mean logMAR visual acuity for the control and intervention group, respectively, was 0.69 and 0.62 (p = 0.3109) pre-operatively and 0.37 and 0.44 (p = 0.3402) post-operatively.

Conclusions : For full-thickness macular hole surgery with ILM peel, there was a trend towards a higher rate of significant well-delineated subfoveal hyporeflective space resolution at 1 and 3 month follow-up with 0.03% ICG staining. A lowered concentration of ICG may lead to earlier resolution of significant well-delineated subfoveal hyporeflective space while still aiding in surgical visualization.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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