BRILLIANT BLUE G-ASSISTED INTERNAL LIMITING MEMBRANE PEELING FOR MACULAR HOLE: A Systematic Review of Literature and Meta-Analysis.
OBJECTIVE
To evaluate the effect of internal limiting membrane peeling with brilliant blue G (BBG) for the treatment of macular hole compared with peeling procedures with other dyes or without dye.


METHODS
MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were systematically reviewed. Outcome measures were the primary closure rate and postoperative best-corrected visual acuity.


RESULTS
Nine studies that included 846 eyes were selected. There was no significant difference in preoperative best-corrected visual acuity between the BBG and no BBG (i.e., other dyes or no dye) groups (mean difference -0.02 logMAR [equivalent to 1 Early Treatment Diabetic Retinopathy Study (ETDRS) letter]; 95% confidence interval -0.09 to 0.04 [-2-4.5 ETDRS letters]; P = 0.45). The macular hole closure rate using BBG was not significantly different from that using indocyanine green (odds ratio 1.98; 95% confidence interval 0.71-5.48; P = 0.19). The postoperative best-corrected visual acuity was more favorable with BBG than with indocyanine green (mean difference -0.10 logMAR [5 ETDRS letters]; 95% confidence interval -0.16 to -0.03 [1.5-8 ETDRS letters]; P = 0.004) or with no BBG (mean difference -0.11 [5.5 ETDRS letters]; 95% confidence interval -0.18 to -0.04 [2-9 ETDRS letters]; P = 0.003).


CONCLUSIONS
BBG could contribute to better visual acuity outcome than other dyes for internal limiting membrane peeling in patients with macular hole; however, it does not significantly influence the closure rate.
*Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan; and†Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Kunihiro
K
Azuma
Yasuo
Y
Noda
Kazunori
K
Hirasawa
Takashi
T
Ueta
D001485:Basement Membrane / Q000473:pathology / Q000601:surgery*; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D007202:Indicators and Reagents / Q000008:administration & dosage*; D011184:Postoperative Period; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012394:Rosaniline Dyes / Q000008:administration & dosage*; D013194:Staining and Labeling / Q000379:methods; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D007202:Indicators and Reagents; D012394:Rosaniline Dyes; C004692:coomassie Brilliant Blue