title: The effects of the intraocular dye brilliant blue G (BBG) mixed with varying concentrations of glucose on retinal function in an isolated perfused vertebrate retina.
abstract: BACKGROUND
  During vitreoretinal surgery, vital dyes such as brilliant blue G (BBG) are used to visualize anatomical structures. By adding glucose to a concentration of 5%, many surgeons try to achieve a dye mixture heavier than water to facilitate staining of the ILM without preceding fluid-air exchange. However, the intraocular use of high glucose concentrations is critical. This study investigated the effect of 0.4 ml BBG (Brilliant Peel™ 0.25 mg/ml, Fluoron, Ulm, Germany) mixed with various glucose concentrations on the retina in an pseudo in vivo model
  
  
  METHODS
  Bovine retinas were isolated and superfused with an oxygen saturated nutrient solution, and the electroretinogram (ERG) was recorded. BBG mixed with 0.05 ml/0.1 ml/0.15 ml glucose 40% was applied epiretinally. ERG recovery was monitored for 75 minutes. 1 mM aspartate was added to the nutrient solution to obtain a-waves.
  
  
  RESULTS
  After application of BBG/0.05 ml 40% glucose, a non-significant decrease of the b-wave amplitude was recorded (11.2%). In contrast, higher glucose concentrations showed a significant decrease of the b-wave (23.40% at 0.1 ml glucose, 26% at 0.15 ml glucose). The a-wave amplitudes showed no significant change at the end of the washout for all concentrations.
  
  
  CONCLUSIONS
  The clinically used mixture of BBG and glucose seems to be safe up to a concentration of 5%. However, higher concentrations of glucose starting from 10% showed strong evidence of a toxic effect on the retinal function and should be avoided.
authors.affiliation: Department of Ophthalmology I, Eberhard-Karls University of Tuebingen, Germany. Kai.Januschowski@med.uni-tuebingen.de
authors.forename: Kai
authors.initials: K
authors.lastname: Januschowski
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mueller
authors.forename: Martin S
authors.initials: MS
authors.lastname: Spitzer
authors.forename: Matthias
authors.initials: M
authors.lastname: Lueke
authors.forename: Karl-Ulrich
authors.initials: KU
authors.lastname: Bartz-Schmidt
authors.forename: Peter
authors.initials: P
authors.lastname: Szurman
mesh_terms: D000818:Animals; D002417:Cattle; D004396:Coloring Agents / Q000633:toxicity*; D004338:Drug Combinations; D004596:Electroretinography / Q000187:drug effects*; D005947:Glucose / Q000633:toxicity*; D012160:Retina / Q000187:drug effects*; D012394:Rosaniline Dyes / Q000633:toxicity*
chemical_list: D004396:Coloring Agents; D004338:Drug Combinations; D012394:Rosaniline Dyes; D005947:Glucose; C004692:coomassie Brilliant Blue