Residual indocyanine green fluorescence pattern after vitrectomy for idiopathic macular hole with internal limiting membrane peeling.
BACKGROUND
Internal limiting membrane (ILM) peeling with indocyanine green (ICG) staining is a commonly used procedure to treat idiopathic macular holes (MH).


OBJECTIVE
To report changes in the patterns of residual ICG fluorescence over time after vitrectomy using the Heidelberg Retina Angiograph 2 (HRA2, Heidelberg Engineering, Heidelberg, Germany).


METHODS
10 patients (10 eyes) who had undergone vitrectomy for MH with ILM peeling were included. 9 (90%) patients underwent ILM peeling with ICG, and 1 (10%) patient had it with triamcinolone acetonide (TA). We observed residual ICG using HRA2, postoperatively. Autofluorescence, optical coherence tomography images and best-corrected visual acuity (BCVA) measurements were also obtained. The minimal follow-up was 3 months.


RESULTS
The MHs were closed postoperatively in all patients (100%). In eyes that underwent ILM peeling with ICG, the BCVA improved significantly (p<0.001) in 8 (89%) eyes and was unchanged in 1 (11%) eye. HRA2 showed the ICG fluorescence patterns but not TA postoperatively. The ICG hyperfluorescent signal was typically diffuse at the posterior retina and was hypofluorescent around the fovea. The hyperfluorescence then migrated towards the optic nerve disc presumably along the nerve fibre, and the area of ILM peeling was clearly identified. A large number of hyperfluorescent dots were observed instead of diffuse hyperfluorescence that was observed just after surgery.


CONCLUSIONS
Patterns of residual ICG fluorescence were sequentially observed with HRA2 after vitrectomy for MH with ICG-assisted ILM peeling.
Sayanagi
Kaori
K
Department of Ophthalmology E7, Osaka University Medical School, Suita 565-0871, Japan.
Ikuno
Yasushi
Y
Soga
Kaori
K
Sawa
Miki
M
Oshima
Yusuke
Y
Kamei
Motohiro
M
Kusaka
Shunji
S
Tano
Yasuo
Y
D000368:Aged; D004396:Coloring Agents / Q000493:pharmacokinetics; D019773:Epiretinal Membrane / Q000378:metabolism / Q000601:surgery*; D005123:Eye / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012167:Retinal Perforations / Q000378:metabolism / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green