Tadayoni Ramin, Paques Michel, Girmens Jean François, Massin Pascale, Gaudric Alain
Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris 7, 2 rue Ambroise Paré, 75010 Paris, France.
Ophthalmology. 2003 Mar;110(3):604-8. doi: 10.1016/S0161-6420(02)01761-X.
To investigate the possible persistence and characteristics of infrared fluorescence of the fundus for several months after surgery with intraocular injection of indocyanine green (ICG).
Interventional, noncomparative, prospective case series.
Seventeen patients operated on in our department with ICG injection into the vitreous cavity, who gave prior informed consent.
After standard three-port pars plana vitrectomy and posterior vitreous detachment, 0.1 to 0.2 ml of an ICG solution at a concentration of 2.5 mg/ml was injected through a 5- micro m sterile filter over the posterior pole and left in place for 3 minutes. The stained internal limiting membrane was then peeled off. Patients had postoperative infrared fundus photographs at each consultation in our department. Follow-up ranged from 1 to 7 months. Visual acuity and any unexpected event were also recorded.
Postoperative infrared fluorescence of the fundus.
The day after surgery, no green ICG staining of the fundus was visible on biomicroscopy. However, infrared photography showed diffuse fluorescence of the fundus. At 1 and 3 postoperative months, infrared fundus photography showed an intensely fluorescent optic nerve disc. In patients with macular hole, the center of the macula also exhibited faint granular fluorescence. At 6 months postoperative or later, only the optic disc remained fluorescent, but the fluorescence was far less intense than at 3 months. Infrared photographs of the fellow eyes exhibited no fluorescence. Visual acuity improved or was unchanged compared with preoperative vision in 16 eyes and decreased by 1 line in 1 eye.
After intraoperative use of ICG for macular surgery, fluorescence of the optic disc and of the macular center after macular hole surgery persisted for months in all cases. ICG may accumulate in the macular pigment epithelium and optic nerve, raising the problem of the as yet unknown pharmacokinetics of ICG after intravitreous administration and of its long-term safety.
研究眼内注射吲哚菁绿（ICG）手术后数月眼底红外荧光的可能持续存在情况及特征。
干预性、非对比性、前瞻性病例系列。
在我院接受手术并向玻璃体腔注射ICG且事先签署知情同意书的17例患者。
在标准三通道平坦部玻璃体切除术及玻璃体后脱离后，通过一个5微米无菌滤器将0.1至0.2毫升浓度为2.5毫克/毫升的ICG溶液注射到后极部上方，并留置3分钟。然后剥除染色的内界膜。患者在我院每次会诊时均进行术后眼底红外照相。随访时间为1至7个月。还记录了视力及任何意外事件。
术后眼底红外荧光。
手术后当天，生物显微镜检查未见眼底有绿色ICG染色。然而，红外照相显示眼底弥漫性荧光。术后1个月和3个月时，眼底红外照相显示视神经盘强烈荧光。在黄斑裂孔患者中，黄斑中心也呈现微弱颗粒状荧光。术后6个月或更晚时，仅视神经盘仍有荧光，但荧光强度远低于3个月时。对侧眼的红外照相未显示荧光。与术前视力相比，16只眼的视力提高或未变，1只眼视力下降1行。
黄斑手术术中使用ICG后，所有病例中视神经盘及黄斑裂孔手术后黄斑中心的荧光持续数月。ICG可能在黄斑色素上皮和视神经中蓄积，引发了玻璃体腔内给药后ICG尚不明确的药代动力学及其长期安全性问题。
