Narayana Nethralaya, Dept. of Retina and Vitreous, #121/C, Chord Road, 1st R block Rajaji Nagar, 560010, Bangalore, India.
Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, 15213, Pittsburg, PA, USA.
BMC Ophthalmol. 2023 Feb 9;23(1):57. doi: 10.1186/s12886-023-02811-w.
The purpose of this study was to look at the long-term effects of retinal phototoxicity after macular hole repair surgery using xenon endolight illumination and Brilliant blue G (BBG) dye.
An elderly man in his late seventies underwent para plana vitrectomy with BBG dye to repair an idiopathic full-thickness macular hole (MH) in his right eye. Prior to macular hole surgery, his visual acuity in the right eye was 6/60, N24 at the time of presentation. The MH closed with type 1 closure immediately after surgery, but there was extensive damage to the outer retinal layers and retinal pigment epithelium (RPE) at the macula, resulting in a reduction in visual acuity to 2/60. We presumed that the combination of BBG and xenon light, is the probable reason of retinotoxicity in the current patient. There was a progressive increase in the area of retinal and RPE layer damage and choroidal thinning over a 4-year period.
Due to combined BBG-induced dye and endoilluminator toxicity, a rare case of continuously progressing RPE layer damage with choroidal thinning over a long follow-up interval was described. Such long-term effects of BBG and endolight induced retinotoxicity have not been reported in the literature, to the best of our knowledge.
本研究旨在观察黄斑裂孔修复术后使用氙气内照明和 Brilliant blue G（BBG）染料引起的视网膜光毒性的长期影响。
一位 70 多岁的老年男性右眼行玻璃体切除术联合 BBG 染料治疗特发性全层黄斑裂孔。黄斑裂孔术前右眼视力为 6/60，就诊时视力为 N24。MH 立即在手术后闭合，但在外视网膜层和黄斑区的视网膜色素上皮（RPE）有广泛的损伤，导致视力下降至 2/60。我们推测 BBG 和氙光的结合是导致当前患者视网膜毒性的可能原因。在 4 年的时间里，视网膜和 RPE 层损伤以及脉络膜变薄的面积逐渐增加。
由于 BBG 诱导的染料和内照明器毒性的共同作用，描述了一例罕见的在长期随访中持续进展的 RPE 层损伤伴脉络膜变薄的病例。据我们所知，目前尚未有文献报道 BBG 和内照明引起的视网膜毒性的这种长期影响。
