Comparison of macular function and visual fields after membrane blue or infracyanine green staining in vitreoretinal surgery

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 248; no. 3; pp. 381 - 388
• Main Authors: Schmid-Kubista, Katharina E., Lamar, Peggy D., Schenk, Alexandra, Stolba, Ulrike, Binder, Susanne
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.03.2010; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Basement Membrane - pathology; Coloring Agents - adverse effects; Epiretinal Membrane - diagnosis; Epiretinal Membrane - surgery; Female; Humans; Indocyanine Green - adverse effects; Indocyanine Green - analogs & derivatives; Macula Lutea - physiology; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Prospective Studies; Retinal Disorders; Retinal Perforations - diagnosis; Retinal Perforations - surgery; Staining and Labeling; Tomography, Optical Coherence; Trypan Blue - adverse effects; Visual Acuity - physiology; Visual Field Tests; Visual Fields - physiology; Vitrectomy; Vitreoretinal surgery; Infracyanine green; Macular hole; Epiretinal membrane; Visual field; Membrane blue
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-009-1213-4

Background To compare possible toxic effects of membrane blue and infracyanine green used as vital stains in macular surgery. Vital stains are used in vitreoretinal surgery to perform peeling of the internal limiting membrane and idiopathic epiretinal membrane. There are many controversial studies about their toxicity, safety, and their effects on the retinal pigment epithelium and the neuroretinal elements. To compare possible toxicities of the two vital stains membrane blue and infracyanine green in vivo, we conducted a prospective, randomized, clinical trial. Methods A prospective, randomized clinical trial including 30 eyes of 30 patients with either full-thickness macular hole or idiopathic epiretinal membrane were included and randomized 1:1 to receive either membrane blue or infracyanine green during vitreoretinal surgery. Complete ophthalmic examinations, including optical coherence tomography and peripheral visual field were performed preoperatively, and 1, 3, and 6 months postoperatively in our clinic. The main outcome measure was the peripheral visual field. Data was analysed with Student’s t -test and Pearson’s correlation coefficient. Results Three months after surgery there was a significant difference in increase in visual field in the superior region in favor of the membrane blue group ( p  = 0.021). Eight eyes (53%) of the infracyanine group had a decrease in temporal visual fields of at least 5°. Conclusion Although there was a significant difference in visual fields between the groups after 3 months in the superior region, there were no more significant differences between the two groups after 6 months. However, due to the decrease in the temporal visual field in some eyes, we conclude that membrane blue is less toxic.