Scotoma formation after exposure of retinal pigmented epithelium to indocyanine green.
OBJECTIVE
To describe objective, clinical evidence of retinal pigmented epithelial (RPE) cell toxicity after exposure to indocyanine green (ICG) in two patients.


METHODS
Using color photos, we show the physical changes in the retina after RPE exposure to ICG. In addition, we present Humphrey visual field examination results, which correlate precisely with sites of ICG contact with the RPE layer.


METHODS
A case series of two patients who underwent vitrectomy and membrane stripping with ICG use by a single surgeon.


RESULTS
Visual examination, color photos, and Humphrey visual field examination results postoperatively reveal scotoma formation corresponding precisely to the size and location of ICG contact with the RPE layer.


CONCLUSIONS
Our two case reports support the theory of ICG solution toxicity to RPE cells, while emphasizing that exposure of RPE to ICG should be avoided in retinal surgery.
From the *Medical Scientist Training Program, Washington University School of Medicine, St. Louis; †Barnes Retina Institute, St. Louis; and ‡Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri.
Shandiz
S
Tehrani
Nancy M
NM
Holekamp