title: Intravital staining of the internal limiting membrane with a novel heavy solution of brilliant blue G.
abstract: BACKGROUND
  The aim of this study was to investigate the hydrodynamic properties and clinical efficacy of a novel heavier-than-water dye (BBG-D₂O) designed for staining of the internal limiting membrane (ILM) during vitreoretinal procedures, consisting of brilliant blue G (BBG, 0.25 mg/mL) with the addition of 13 % of deuterium oxide (D₂O).
  
  
  METHODS
  The gravity-related hydrodynamic distribution of BBG-D₂O was measured in 7 experiments using standard test cuvettes filled with balanced salt solution (BSS). BBG-D₂O was applied in 3 patients (2 × epiretinal membrane [ERM], 1 × vitreous traction and lamellar macular hole) for the staining of the ILM.
  
  
  RESULTS
  Compared to standard solutions of BBG the heavy version of the dye (BBG-D₂O) presented a rapid flow towards the bottom of test cuvettes. After 15 seconds the concentration of BBG solutions in the lowest 25 % of the cuvette volumes was 4.2 ± 0.2 µg/mL (mean ± standard deviation) compared to 19.0 ± 2.6 µg/mL of BBG-D₂O (p < 0.0005). Clinically BBG-D₂O resulted in a strong staining effect of the ILM, comparable to conventional indocyanine green (ICG) solution and clearly more intensive than that of conventional BBG solution of the same concentration (0.25 mg/mL). The intensive staining effect of primary applied BBG-D₂O before epiretinal membrane removal allowed an en bloc peeling of ILM and ERM as a one-step procedure. No sign of any adverse effects related to the use of BBG-D₂O were observed.
  
  
  CONCLUSIONS
  Heavy brilliant blue G (BBG-D₂O) provides a significantly improved staining effect of the ILM and by this makes ILM peeling more efficient, easier, faster and less traumatic.
authors.affiliation: Department of Retinology, Klinik Pallas, Olten, Switzerland. hgerding@klinik-pallas.ch
authors.forename: H
authors.initials: H
authors.lastname: Gerding
authors.forename: M
authors.initials: M
authors.lastname: Timmermann
authors.forename: U
authors.initials: U
authors.lastname: Thelen
mesh_terms: D000368:Aged; D019773:Epiretinal Membrane / Q000473:pathology*; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000032:analysis; D008297:Male; D012394:Rosaniline Dyes / Q000032:analysis*; D012996:Solutions
chemical_list: D007202:Indicators and Reagents; D012394:Rosaniline Dyes; D012996:Solutions; C004692:coomassie Brilliant Blue