Skip to main content
Top
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 1/2007

01-01-2007 | Short Communication

Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling

Authors: Timothy Y. Y. Lai, Alvin K. H. Kwok, Amy W. H. Au, Dennis S. C. Lam

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 1/2007

Login to get access

Abstract

Purpose

To evaluate the changes in macular function and potential retinal toxicity in epiretinal membrane (ERM) surgery with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling using multifocal electroretinography (mfERG).

Methods

Thirteen eyes of 13 patients were randomly assigned to have ERM surgery with ILM peeling using 0.5 mg/ml or 1.25 mg/ml ICG staining. Patients were examined at baseline and at 3 and 6 months postoperatively. The postoperative mfERG N1 and P1 response amplitudes and peak latencies of various ring eccentricities were assessed and compared with baseline to determine any serial changes.

Results

After surgery, the median best-corrected visual acuity improved from 20/70 at baseline to 20/30 at 6 months postoperatively (Wilcoxon signed-ranks test, P=0.004). At 3 months postoperatively, the 0.5 mg/ml group showed no significant changes in N1 and P1 response amplitudes and peak latencies, whereas the 1.25 mg/ml ICG group showed significant reductions in N1 and P1 response amplitudes compared with baseline. No significant changes in mfERG responses were observed in either group at 6 months after surgery.

Conclusions

Our mfERG findings suggested that the use of a higher concentration of ICG for ILM staining might result in transient retinal functional impairment postoperatively. The lowest possible concentration of ICG should be used intraoperatively to minimize potential retinal toxicity.
Literature
1.
go back to reference Haritoglou C, Gandorfer A, Gass CA, Schaumberger M, Ulbig MW, Kampik A (2003) The effect of indocyanine-green on functional outcome of macular pucker surgery. Am J Ophthalmol 135:328–337PubMedCrossRef Haritoglou C, Gandorfer A, Gass CA, Schaumberger M, Ulbig MW, Kampik A (2003) The effect of indocyanine-green on functional outcome of macular pucker surgery. Am J Ophthalmol 135:328–337PubMedCrossRef
2.
go back to reference Hasumura T, Yonemura N, Hirata A, Murata Y, Negi A (2000) Retinal damage by air infusion during vitrectomy in rabbit eyes. Invest Ophthalmol Vis Sci 41:4300–4304PubMed Hasumura T, Yonemura N, Hirata A, Murata Y, Negi A (2000) Retinal damage by air infusion during vitrectomy in rabbit eyes. Invest Ophthalmol Vis Sci 41:4300–4304PubMed
3.
go back to reference Hillenkamp J, Saikia P, Gora F, Sachs HG, Lohmann CP, Roider J, Baumler W, Gabel VP (2005) Macular function and morphology after peeling of idiopathic epiretinal membrane with and without the assistance of indocyanine green. Br J Ophthalmol 89:437–443PubMedCrossRef Hillenkamp J, Saikia P, Gora F, Sachs HG, Lohmann CP, Roider J, Baumler W, Gabel VP (2005) Macular function and morphology after peeling of idiopathic epiretinal membrane with and without the assistance of indocyanine green. Br J Ophthalmol 89:437–443PubMedCrossRef
4.
go back to reference Hood DC, Seiple W, Holopigian K, Greenstein V (1997) A comparison of the components of the multifocal and full-field ERGs. Vis Neurosci 14:533–544PubMedCrossRef Hood DC, Seiple W, Holopigian K, Greenstein V (1997) A comparison of the components of the multifocal and full-field ERGs. Vis Neurosci 14:533–544PubMedCrossRef
5.
go back to reference Horio N, Horiguchi M (2004) Effect on visual outcome after macular hole surgery when staining the internal limiting membrane with indocyanine green dye. Arch Ophthalmol 122:992–996PubMedCrossRef Horio N, Horiguchi M (2004) Effect on visual outcome after macular hole surgery when staining the internal limiting membrane with indocyanine green dye. Arch Ophthalmol 122:992–996PubMedCrossRef
6.
go back to reference Ikagawa H, Yoneda M, Iwaki M, Isogai Z, Tsujii K, Yamazaki R, Kamiya T, Zako M (2005) Chemical toxicity of indocyanine green damages retinal pigment epithelium. Invest Ophthalmol Vis Sci 46:2531–2539PubMedCrossRef Ikagawa H, Yoneda M, Iwaki M, Isogai Z, Tsujii K, Yamazaki R, Kamiya T, Zako M (2005) Chemical toxicity of indocyanine green damages retinal pigment epithelium. Invest Ophthalmol Vis Sci 46:2531–2539PubMedCrossRef
7.
go back to reference Jackson TL, Hillenkamp J, Knight BC, Zhang JJ, Thomas D, Stanford MR, Marshall J (2004) Safety testing of indocyanine green and trypan blue using retinal pigment epithelium and glial cell cultures. Invest Ophthalmol Vis Sci 45:2778–2785PubMedCrossRef Jackson TL, Hillenkamp J, Knight BC, Zhang JJ, Thomas D, Stanford MR, Marshall J (2004) Safety testing of indocyanine green and trypan blue using retinal pigment epithelium and glial cell cultures. Invest Ophthalmol Vis Sci 45:2778–2785PubMedCrossRef
8.
go back to reference Kawji T, Hirata A, Inomata Y, Koga T, Tanihara H (2004) Morphological damage in rabbit retina caused by subretinal injection of indocyanine green. Graefes Arch Clin Exp Ophthalmol 242:158–164CrossRef Kawji T, Hirata A, Inomata Y, Koga T, Tanihara H (2004) Morphological damage in rabbit retina caused by subretinal injection of indocyanine green. Graefes Arch Clin Exp Ophthalmol 242:158–164CrossRef
9.
go back to reference Kodjikian L, Richter T, Halberstadt M, Beby F, Flueckiger F, Boehnke M, Garweg JG (2005) Toxic effects of indocyanine green, infracyanine green, and trypan blue on the human retinal pigmented epithelium. Graefes Arch Clin Exp Ophthalmol 243:917–925PubMedCrossRef Kodjikian L, Richter T, Halberstadt M, Beby F, Flueckiger F, Boehnke M, Garweg JG (2005) Toxic effects of indocyanine green, infracyanine green, and trypan blue on the human retinal pigmented epithelium. Graefes Arch Clin Exp Ophthalmol 243:917–925PubMedCrossRef
10.
go back to reference Kwok AK, Lai TY, Yew DT, Li WW (2003) Internal limiting membrane staining with various concentrations of indocyanine green dye under air in macular surgeries. Am J Ophthalmol 136:223–230PubMedCrossRef Kwok AK, Lai TY, Yew DT, Li WW (2003) Internal limiting membrane staining with various concentrations of indocyanine green dye under air in macular surgeries. Am J Ophthalmol 136:223–230PubMedCrossRef
11.
go back to reference Kwok AK, Lai TY, Li WW, Woo DC, Chan NR (2004) Indocyanine green assisted internal limiting membrane removal in epiretinal membrane surgery: a clinical and histological study. Am J Ophthalmol 138:194–199PubMedCrossRef Kwok AK, Lai TY, Li WW, Woo DC, Chan NR (2004) Indocyanine green assisted internal limiting membrane removal in epiretinal membrane surgery: a clinical and histological study. Am J Ophthalmol 138:194–199PubMedCrossRef
12.
go back to reference Kwok AK, Lai TY, Yuen KS (2005) Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Exp Ophthalmol 33:379–385CrossRef Kwok AK, Lai TY, Yuen KS (2005) Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Exp Ophthalmol 33:379–385CrossRef
13.
go back to reference Kwok AK, Lai TY, Yeung CK, Yeung YS, Li WW, Chiang SW (2005) The effects of indocyanine green and endoillumination on rabbit retina: an electroretinographic and histological study. Br J Ophthalmol 89:897–900PubMedCrossRef Kwok AK, Lai TY, Yeung CK, Yeung YS, Li WW, Chiang SW (2005) The effects of indocyanine green and endoillumination on rabbit retina: an electroretinographic and histological study. Br J Ophthalmol 89:897–900PubMedCrossRef
14.
go back to reference Marmor MF, Hood DC, Keating D, Kondo M, Seeliger MW, Miyake Y; International Society for Clinical Electrophysiology of Vision (2003) Guidelines for basic multifocal electroretinography (mfERG). Doc Ophthalmol 106:105–115PubMedCrossRef Marmor MF, Hood DC, Keating D, Kondo M, Seeliger MW, Miyake Y; International Society for Clinical Electrophysiology of Vision (2003) Guidelines for basic multifocal electroretinography (mfERG). Doc Ophthalmol 106:105–115PubMedCrossRef
15.
go back to reference Moschos M, Apostolopoulos M, Ladas J, Theodossiadis P, Malias J, Moschos M, Papaspirou A, Theodossiadis G (2001) Assessment of macular function by multifocal electroretinogram before and after epimacular membrane surgery. Retina 21:590–595PubMedCrossRef Moschos M, Apostolopoulos M, Ladas J, Theodossiadis P, Malias J, Moschos M, Papaspirou A, Theodossiadis G (2001) Assessment of macular function by multifocal electroretinogram before and after epimacular membrane surgery. Retina 21:590–595PubMedCrossRef
16.
go back to reference Murata M, Shimizu S, Horiuchi S, Sato S (2005) The effect of indocyanine green on cultured retinal glial cells. Retina 25:75–80PubMedCrossRef Murata M, Shimizu S, Horiuchi S, Sato S (2005) The effect of indocyanine green on cultured retinal glial cells. Retina 25:75–80PubMedCrossRef
17.
go back to reference Oh KT, Boldt HC, Maturi RK, Folk JC, Kardon RH (2000) Evaluation of patients with visual field defects following macular hole surgery using multifocal electroretinography. Retina 20:238–243PubMedCrossRef Oh KT, Boldt HC, Maturi RK, Folk JC, Kardon RH (2000) Evaluation of patients with visual field defects following macular hole surgery using multifocal electroretinography. Retina 20:238–243PubMedCrossRef
18.
go back to reference Park DW, Dugel PU, Garda J, Sipperley JO, Thach A, Sneed SR, Blaisdell J (2003) Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 110:62–64PubMedCrossRef Park DW, Dugel PU, Garda J, Sipperley JO, Thach A, Sneed SR, Blaisdell J (2003) Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 110:62–64PubMedCrossRef
19.
go back to reference Sebag J (2004) Indocyanine green-assisted macular hole surgery: too pioneering? Am J Ophthalmol 137:744–746PubMed Sebag J (2004) Indocyanine green-assisted macular hole surgery: too pioneering? Am J Ophthalmol 137:744–746PubMed
20.
go back to reference Sorcinelli R (2003) Surgical management of epiretinal membrane with indocyanine-green-assisted peeling. Ophthalmologica 217:107–110PubMedCrossRef Sorcinelli R (2003) Surgical management of epiretinal membrane with indocyanine-green-assisted peeling. Ophthalmologica 217:107–110PubMedCrossRef
21.
go back to reference Stalmans P, Van Aken EH, Veckeneer M, Feron EJ, Stalmans I (2002) Toxic effect of indocyanine green on retinal pigment epithelium related to osmotic effects of the solvent. Am J Ophthalmol 134:282–285PubMedCrossRef Stalmans P, Van Aken EH, Veckeneer M, Feron EJ, Stalmans I (2002) Toxic effect of indocyanine green on retinal pigment epithelium related to osmotic effects of the solvent. Am J Ophthalmol 134:282–285PubMedCrossRef
22.
go back to reference Terasaki H, Miyake Y, Nomura R, Piao CH, Hori K, Niwa T, Kondo M (2001) Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery. Invest Ophthalmol Vis Sci 42:229–234PubMed Terasaki H, Miyake Y, Nomura R, Piao CH, Hori K, Niwa T, Kondo M (2001) Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery. Invest Ophthalmol Vis Sci 42:229–234PubMed
23.
go back to reference Yam HF, Kwok AK, Chan KP, Lai TY, Chu KY, Lam DS, Pang CP (2003) Effect of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci 44:370–377PubMedCrossRef Yam HF, Kwok AK, Chan KP, Lai TY, Chu KY, Lam DS, Pang CP (2003) Effect of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci 44:370–377PubMedCrossRef
24.
go back to reference Yip HF, Lai TY, So KF, Kwok AK (2006) Retinal ganglion cells toxicity caused by photosensitizing effects of intravitreal indocyanine green with illumination in rat eyes. Br J Ophthalmol 90:99–102PubMedCrossRef Yip HF, Lai TY, So KF, Kwok AK (2006) Retinal ganglion cells toxicity caused by photosensitizing effects of intravitreal indocyanine green with illumination in rat eyes. Br J Ophthalmol 90:99–102PubMedCrossRef
Metadata
Title
Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling
Authors
Timothy Y. Y. Lai
Alvin K. H. Kwok
Amy W. H. Au
Dennis S. C. Lam
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 1/2007
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-006-0352-0

Other articles of this Issue 1/2007

Graefe's Archive for Clinical and Experimental Ophthalmology 1/2007 Go to the issue