title: Comparisons of cone electroretinograms after indocyanine green-, brilliant blue G-, or triamcinolone acetonide-assisted macular hole surgery.
abstract: OBJECTIVE
  To compare the function of retinal ganglion cells (RGCs) using the photopic negative response (PhNR) in patients who had undergone indocyaine green (ICG)-assisted, brilliant blue G (BBG)-assisted, or triamcinolone acetonide (TA)-assisted internal limiting membrane (ILM) peeling during macular hole (MH) surgery.
  
  
  METHODS
  Forty-eight eyes of 48 patients with a macular hole were randomly divided into those undergoing ICG-assisted, BBG-assisted, or TA-assisted vitrectomy (n = 16 for each group). Full-field cone ERGs were recorded before and 1, 3, 6, 9, and 12 months postoperatively. The amplitudes and implicit times of the a-waves and b-waves and the amplitudes of the oscillatory potentials (OPs) and PhNRs were measured. The mean deviations (MDs) of standard automated perimetry and the best-corrected visual acuity (BCVA) were measured. The circumferential retinal nerve fiber layer (RNFL) thickness was evaluated by SD-OCT.
  
  
  RESULTS
  All macular holes were closed with a significant improvement of the BCVA and MD without differences among the groups. There was no significant difference between the preoperative and postoperative RNFL thickness. The implicit times of the a-waves and b-waves were significantly prolonged, and the ΣOPs amplitude was significantly decreased postoperatively in all groups. These ERG changes were not significantly different among the groups. The postoperative PhNR amplitudes were significantly lower in the ICG group than in the BBG or TA group.
  
  
  CONCLUSIONS
  The results indicate that the PhNR may detect subclinical impairments of RGCs caused by the possible toxic effect of ICG. This finding adds to the data that BBG and TA may be safer than ICG for use during MH surgery.
authors.affiliation: Department of Ophthalmology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan, smachida57@gmail.com.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Machida
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Toba
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Nishimura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohzeki
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Murai
authors.forename: Daijiro
authors.initials: D
authors.lastname: Kurosaka
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D004396:Coloring Agents; D004596:Electroretinography; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D018918:Phacoemulsification; D017949:Retinal Cone Photoreceptor Cells / Q000502:physiology*; D012165:Retinal Ganglion Cells / Q000502:physiology; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D012394:Rosaniline Dyes; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D014821:Vitrectomy
chemical_list: D004396:Coloring Agents; D005938:Glucocorticoids; D012394:Rosaniline Dyes; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green; C004692:coomassie Brilliant Blue