ABSTRACT

Purpose

Vitrectomy with brilliant blue G (BBG) assisted internal limiting membrane (ILM) peeling is the standard operational technique in macular hole surgeries. However, BBG dye, though considered safe and nontoxic, can also occasionally lead to macular toxicity. This study aims to describe the clinical features and characteristics of four eyes who developed macular toxicity after following surgery for macular hole repair.

Methods

Retrospective review of four consecutive cases of macular toxicity after conventional BBG assisted ILM peeling. All the cases reviewed, their operative surgical notes were retrieved and analyzed. The ILM was stained twice during surgery with prolonged intraoperative surgical time.

Results

All four cases had a prolonged surgical time and the ILM was stained twice during surgery in all cases. The area of macular toxicity was corresponding to the area of ILM peeling which had been exposed to repeated staining by BBG dye. By the end of one month, all four cases had foveal thinning along with choriocapillary atrophy. The mean BCVA was 20/80 before surgery and the final mean visual acuity was <20/800.

Conclusion

This report highlights the occurrence of macular and choriocapillary atrophy due to prolonged focal endoillumination and the increased risk of toxicity with repeated dye staining.

中文翻译：

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黄斑裂孔手术中的亮蓝 G 毒性：光毒性和染料诱导的黄斑损伤联合报告

摘要

目的

采用亮蓝色 G (BBG) 辅助内界膜 (ILM) 剥离的玻璃体切除术是黄斑裂孔手术的标准操作技术。然而，BBG 染料虽然被认为是安全无毒的，但偶尔也会导致黄斑毒性。本研究旨在描述四只眼在黄斑裂孔修复术后出现黄斑毒性的临床特征和特征。

方法

常规 BBG 辅助 ILM 剥离后连续四例黄斑毒性的回顾性研究。回顾所有病例，检索和分析他们的手术记录。手术期间ILM被染色两次，术中手术时间延长。

结果

所有四个病例的手术时间都延长了，并且在所有病例的手术过程中ILM都被染色了两次。黄斑毒性区域对应于ILM剥落的区域，该区域已经暴露于BBG染料的重复染色。1个月末，4例均出现中央凹变薄并伴有脉络膜毛细血管萎缩。术前平均 BCVA 为 20/80，最终平均视力 <20/800。

结论

本报告强调了由于长时间局灶内照明而导致黄斑和脉络膜毛细血管萎缩的发生以及反复染料染色的毒性风险增加。