Comparative Evaluation of Retinal Nerve Fiber Layer Thickness After Conventional Brilliant Blue Assisted Internal Limiting Membrane Peeling Versus Brilliant Blue Selective Staining Using Whole Blood in Macular Hole Surgery

Ophthalmic Surg Lasers Imaging Retina. 2016 May 1;47(5):436-42. doi: 10.3928/23258160-20160419-06.

Abstract

Background and objective: To evaluate retinal nerve fiber layer (RNFL) thickness after conventional brilliant blue (BB) assisted macular hole (MH) surgery versus BB selective staining using whole blood (WB) in MH surgery.

Patients and methods: Sixty eyes with stage 4 idiopathic MH with a clear media were randomly divided into two equal groups. Group A eyes underwent sequential intraoperative use of autologous heparinized WB followed by BB dye for staining internal limiting membrane, whereas eyes in group B were subjected to conventional BB staining. Clinical examination and spectral-domain optical coherence tomography was done preoperatively and postoperatively up to 6 months.

Results: Mean global RNFL thickness and mean temporal RNFL thickness decreased in both groups postoperatively, but the reduction in RNFL thickness in group B was greater than group A at all postoperative visits (P < .05).

Conclusion: BB toxicity may be responsible for reduction of RNFL thickness and WB appears to protect RNFL against dye toxicity. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:436-442.].

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Benzenesulfonates / therapeutic use*
  • Endotamponade / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Retinal Ganglion Cells / pathology*
  • Retinal Perforations / therapy*
  • Staining and Labeling / methods
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / methods*

Substances

  • Benzenesulfonates
  • brilliant blue