title: Comparison of vitrectomy with brilliant blue G or indocyanine green on retinal microstructure and function of eyes with macular hole.
abstract: OBJECTIVE
  To evaluate the microstructure of the inner and outer retina and the visual function after macular hole (MH) surgery using brilliant blue G (BBG) or indocyanine green (ICG) to make the internal limiting membrane (ILM) more visible.
  
  
  METHODS
  Comparative, retrospective, interventional case series.
  
  
  METHODS
  Sixty-three eyes of 63 consecutive cases with MH were studied. Thirty-five eyes of 35 cases were treated with BBG between January and August 2011. Twenty-eight eyes of 28 MH cases were treated with ICG from April 2009 through April 2010.
  
  
  METHODS
  Vitrectomy was performed with a 23-gauge system and 0.25 mg/ml BBG or with 0.125% ICG.
  
  
  METHODS
  The best-corrected visual acuity (BCVA) and the microperimetry-determined retinal sensitivity were measured at baseline and at 3 and 6 months after surgery. The length of the defect of the photoreceptor inner segment/outer segment (IS/OS) junction and external limiting membrane (ELM), the central foveal thickness (CFT), and the thickness of the ganglion cell complex (GCC) were measured in the spectral-domain optical coherence tomographic images.
  
  
  RESULTS
  The average BCVA was significantly better in the BBG group than in the ICG group at 3 months (P = 0.021) and 6 months (P = 0.045) after surgery. The mean retinal sensitivity in the BBG group was improved significantly in the central 2° at 3 and 6 months (P = 0.001 and P = 0.030, respectively), but was not significantly improved in the adjacent 10°. The length of IS/OS junction defect was significantly shorter in the BBG group at 3 months (P = 0.048), but was not significantly different at 6 months (P = 0.135). The length of ELM defect and the GCC thickness were not significantly different between the 2 groups at 3 and 6 months. The CFT was significantly thinner in the ICG group than in the BBG group at 3 and 6 months (P = 0.013 and P = 0.001, respectively).
  
  
  CONCLUSIONS
  The postoperative BCVA and retinal sensitivity in the central 2° were better in eyes after BBG-assisted vitrectomy. The restoration of IS/OS junction was faster in the BBG group, and the CFT was significantly thinner in eyes after ICG. Brilliant blue G may be a better agent than ICG to make the ILM more visible.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan. babatakayuki@nifty.com
authors.forename: Takayuki
authors.initials: T
authors.lastname: Baba
authors.forename: Akira
authors.initials: A
authors.lastname: Hagiwara
authors.forename: Eiju
authors.initials: E
authors.lastname: Sato
authors.forename: Miyuki
authors.initials: M
authors.lastname: Arai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oshitari
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D012165:Retinal Ganglion Cells / Q000473:pathology; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; D007208:Indocyanine Green; C004692:coomassie Brilliant Blue