Abstract
Purpose :
Dispersion and epithelial-mesenchymal transition of retinal pigmented epithelial (RPE) cells in rhegmatogenous retinal detachments (RRD) may lead to the development of proliferative vitreoretinopathy (PVR). Currently, there are no proven preventative pharmacologic therapies. Indocyanine green (ICG) has been reported to be toxic to RPE cells but its use in prevention of PVR has not been studied. We performed a retrospective matched case-control study to evaluate whether the use of ICG during primary RRD repair may lower the risk of PVR development.
Methods :
A retrospective matched case-control series was performed identifying patients who underwent pars plana vitrectomy (PPV) with or without scleral buckling (SB) for primary RRD repair with and without the use of 0.25% ICG. No membrane peeling was performed in either group. Both groups were matched according to age, gender, visual acuity (VA) before surgery, lens and macula status, type of surgical procedure, gauge, laser to breaks, and tamponade (Table 1). Exclusion criteria consisted of patients with previous posterior segment surgeries, history of proliferative diabetic retinopathy, and/or presence of PVR. Both groups were followed for 12 months. The primary outcome measure was development of grade C or worse PVR re-detachment. Secondary measures included change in VA and development of epiretinal membrane (ERM). For statistical analysis, the chi square, independent t-test, and paired t-test were used.
Results :
A total of 104 patients were included, 52 in the ICG group and 52 in the matched control group. Post-operative PVR re-detachments had occurred in 3/38 ICG patients and 1/45 controls by month 12 (p=0.26) and 4/52 ICG patients and 3/51 controls by the final visit (p=0.72). ERM was present in 12/41 ICG patients and 22/45 controls at month 12 (p=0.063) and 22/52 ICG patients and 30/52 controls at final visit (p=0.07). The mean (SD) LogMAR [Snellen] VA was 0.54 (0.57) [20/69] in the ICG group and 0.38 (0.56) [20/48] in the control group at 12 months (p=0.16). At the final visit, the mean (SD) logMAR [Snellen] VA was 0.45 (0.59) [20/56] in the ICG group and 0.34 (0.51) [20/44] (p=0.11).
Conclusions :
ICG did not appear to prevent PVR or ERM formation after prophylactic use during primary PPV for RRD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.