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ICG reduced visual acuity gains after macular hole surgery
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The use of indocyanine green dye to stain the internal limiting membrane can negatively affect visual recovery after macular hole surgery, according to a report by Japanese researchers.
“The results suggest that ICG staining should not be used as long as the visibility of the retinal surface is good. However, ICG staining may be acceptable at a low concentration when a clear view of the retinal surface is unattainable,” the authors said.
Naoichi Horio, MD, and Massyuki Horiguchi, MD, randomized 40 eyes of 38 patients with idiopathic macular holes to compare internal limiting membrane (ILM) peeling with and without ICG staining.
In all cases, the macular holes were successfully closed, and both groups had an improvement in visual acuity. However, postop VA was significantly better in the non-ICG group, and improvement of VA was also significantly better in that group, the study authors said.
Median postop VA was 0.85 in non-ICG-stained patients and 0.6 in ICG-stained patients (P = .02) at 12 months, according to the study.
No difference between the groups was seen in multifocal electroretinogram or optical coherence tomography. Some patients in both groups had weak hyperfluorescence at the macula on fluorescein angiograms.
The differences in visual recovery are probably due to the effects of ICG on ganglion cells and their axons in addition to pigment epithelial cell damage and toxic effects to the retina, the authors said.
The study is published in Archives of Ophthalmology.