Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1Takatsu-ku, FutagoKawasaki, Kanagawa, 213-8507, Japan.
Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan.
Jpn J Ophthalmol. 2021 Sep;65(5):689-697. doi: 10.1007/s10384-021-00851-7. Epub 2021 Jul 1.
Vital dyes are frequently used to visualize the internal limiting membrane (ILM) of the neuroretina. This study evaluated and compared the microstructure of the inner retina and visual function with and without brilliant blue G (BBG) staining for ILM peeling during idiopathic epiretinal membrane (ERM) surgery.
Retrospective, consecutive, interventional case series.
Fifty-five patients (55 eyes) with ERM underwent ILM peeling without dyes (non-dye group) and 55 patients (55 eyes) underwent ILM peeling with BBG staining (BBG group). The logMAR visual acuity (VA) and ganglion cell complex (GCC) thickness were measured using optical coherence tomography at baseline and 12 months after surgery.
LogMAR VA improved significantly in both groups at 12 months and the BBG group tended to be better than the non-dye group but with no significant difference between the groups (unpaired t-test, P = 0.490). The average GCC thickness significantly decreased in both groups; however, there was no difference in the rates of change in GCC thickness between the groups. The ratio of GCC thickness to total retinal thickness (%) was significantly higher in the BBG group in the superior quadrant at 12 months postoperatively (P = 0.010).
BBG-assisted ERM surgery resulted in better visual improvement and fewer structural changes in the inner retinal layers. BBG-assisted ILM peeling is safe both functionally and anatomically.
生命染料常用于可视化神经视网膜的内界膜(ILM)。本研究评估和比较了特发性视网膜前膜(ERM)手术中使用和不使用亮蓝 G(BBG)进行 ILM 剥离时内视网膜的微观结构和视觉功能。
回顾性、连续、干预性病例系列。
55 例(55 只眼)ERM 患者行无染料 ILM 剥离(非染料组),55 例(55 只眼)行 BBG 染色 ILM 剥离(BBG 组)。基线和术后 12 个月使用光学相干断层扫描测量 logMAR 视力(VA)和节细胞复合体(GCC)厚度。
两组术后 12 个月 logMAR VA 均显著提高,BBG 组优于非染料组,但两组间无显著差异(未配对 t 检验,P=0.490)。两组平均 GCC 厚度均显著降低,但两组间 GCC 厚度变化率无差异。术后 12 个月,BBG 组上象限的 GCC 厚度与总视网膜厚度的比值(%)显著升高(P=0.010)。
BBG 辅助 ERM 手术可改善视力,减少内视网膜结构变化。BBG 辅助 ILM 剥离在功能和解剖上均安全。