Changes in retinal pigment epithelium after indocyanine green-assisted internal limiting lamina peeling during macular hole surgery.
OBJECTIVE
To determine the changes in the retinal pigment epithelium (retinal pigment epithelium) and secondary changes in the choroid and fovea after indocyanine green (ICG) staining of the internal limiting lamina during surgery for an idiopathic macular hole (MH).


METHODS
Observational case series.


METHODS
The medical charts of 31 patients who underwent MH surgical procedures with internal limiting lamina staining and peeling were reviewed. The eyes were examined by optical coherence tomography, scanning laser ophthalmoscopy, fluorescein, and ICG angiography.


RESULTS
In three cases that experienced retinal pigment epithelium changes, there was foveal thinning and choriocapillary atrophy in the area of the previous MH. The visual acuity was markedly worse, and the retina was markedly thinner in these three cases than in the other cases without retinal pigment epithelium changes (P = .003, P = .009, respectively).


CONCLUSIONS
The use of ICG dye with illumination may increase the risk of retinal pigment epithelium damage and secondary choroidal and foveal morphologic changes.
Uemoto
Riyo
R
Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan. minami111@nyc.odn.ne.jp
Yamamoto
Shuichi
S
Takeuchi
Shinobu
S
D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D015862:Choroid Diseases / Q000139:chemically induced* / Q000175:diagnosis; D004396:Coloring Agents / Q000009:adverse effects*; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green / Q000009:adverse effects*; D010857:Pigment Epithelium of Eye / Q000187:drug effects* / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D013194:Staining and Labeling / Q000379:methods; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green