Atypical Retinal Hemorrhages after Vitrectomy for Idiopathic Macular Hole: Possible Toxicity of Brilliant Blue G
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To describe the development of multiple retinal hemorrhages after uncomplicated macular hole (MH) surgery, andto determine the associated factors. Methods: The medical records of 163 patients (167 eyes) diagnosed with idiopathic MHs and who underwent surgery atPusan National University Hospital between March 2016 and July 2018 were retrospectively reviewed. The development ofretinal hemorrhages was evaluated using ultra-widefield fundus photographs. Multiple retinal hemorrhages were defined asthree or more dot or blot hemorrhages that had not been observed before and during the surgery. The patients were dividedinto two groups according to the presence of multiple retinal hemorrhages. The variable parameters were compared betweenthe two groups to find the risk factors. The associated factors were evaluated further for the independent factor usingmultiple logistic regression analysis. Results: Multiple retinal hemorrhages were observed in 31 eyes (18.6%) after MH surgery. The associated factors were thesurgical induction of posterior vitreous detachment (PVD) (p = 0.003), use of the internal limiting membrane flap technique (p= 0.028), and staining with Brilliant Blue G (BBG) (p = 0.003). Retinal hemorrhages were exclusively observed in eyes in whichBBG was used. Surgical PVD induction was the only independent risk factor (odds ratio, 13.099; p = 0.013). No statisticallysignificant differences were observed between the two groups in the postoperative visual outcomes and MH closure rate. Additionally, patients who underwent surgery for idiopathic epiretinal membrane during the study period were reviewed tovalidate the above findings. Multiple retinal hemorrhages were noted in only one case (0.4%) in which BBG was used aftersurgical induction of PVD. Conclusions: Multiple retinal hemorrhages after MH surgery appear to be related to the intravitreal use of BBG in eyes thatsustained mechanical damage because of surgical induction of PVD; however, they did not affect surgical outcomes.
Abstract
Purpose: To describe the development of multiple retinal hemorrhages after uncomplicated macular hole (MH) surgery, andto determine the associated factors. Methods: The medical records of 163 patients (167 eyes) diagnosed with idiopathic MHs and who underwent surgery atPusan National University Hospital between March 2016 and July 2018 were retrospectively reviewed. The development ofretinal hemorrhages was evaluated using ultra-widefield fundus photographs. Multiple retinal hemorrhages were defined asthree or more dot or blot hemorrhages that had not been observed before and during the surgery. The patients were dividedinto two groups according to the presence of multiple retinal hemorrhages. The variable parameters were compared betweenthe two groups to find the risk factors. The associated factors were evaluated further for the independent factor usingmultiple logistic regression analysis. Results: Multiple retinal hemorrhages were observed in 31 eyes (18.6%) after MH surgery. The associated factors were thesurgical induction of posterior vitreous detachment (PVD) (p = 0.003), use of the internal limiting membrane flap technique (p= 0.028), and staining with Brilliant Blue G (BBG) (p = 0.003). Retinal hemorrhages were exclusively observed in eyes in whichBBG was used. Surgical PVD induction was the only independent risk factor (odds ratio, 13.099; p = 0.013). No statisticallysignificant differences were observed between the two groups in the postoperative visual outcomes and MH closure rate. Additionally, patients who underwent surgery for idiopathic epiretinal membrane during the study period were reviewed tovalidate the above findings. Multiple retinal hemorrhages were noted in only one case (0.4%) in which BBG was used aftersurgical induction of PVD. Conclusions: Multiple retinal hemorrhages after MH surgery appear to be related to the intravitreal use of BBG in eyes thatsustained mechanical damage because of surgical induction of PVD; however, they did not affect surgical outcomes.
참고문헌 (26)
- la Cour M, "Macular holes: classification, epidemiology, natural history and treatment", Acta Ophthalmol Scand, 80, pp.579~587 (2002)
- Mester V, "Internal limiting membrane removal in the management of full-thickness macular holes", Am J Ophthalmol, 129, pp.769~777 (2000)
- Shin MK, "Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery", Retina, 34, pp.1905~1910 (2014)
- Park SS, "Posterior segment complications after vitrectomy for macular hole", Ophthalmology, 102, pp.775~781 (1995)
- Kim JH, "Asymmetric elongation of foveal issue after macular hole surgery and its impact on metamorphopsia", Ophthalmology, 119, pp.2133~2140 (2012)
- Park SH, "Square grid deformation analysis of the macula and postoperative metamorphopsia after macular hole surgery", Retina, 41, pp.931~939 (2021)
- Ito Y, "Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes", Ophthalmology, 112, pp.1415~1420 (2005)
- Baba T, "Comparison of vitrectomy with brilliant blue G or indocyanine green on retinal microstructure and function of eyes with macular hole", Ophthalmology, 119, pp.2609~2615 (2012)
- Mikosz CA, "Fungal endophthalmitis associated with compounded products", Emerg Infect Dis, 20, pp.248~256 (2014)
- Jabs DA, "Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop", Am J Ophthalmol, 140, pp.509~516 (2005)
- Enaida H, "Brilliant blue G selectively stains the internal limiting membrane", brilliant blue G-assisted membrane peeling, 2006, pp.26, 631~636
- Godley BF, "Retinal hemorrhages as an early sign of acute bacterial endophthalmitis", Am J Ophthalmol, 116, pp.247~249 (1993)
- Relhan N, "Traumatic endophthalmitis presenting as isolated retinal vasculitis and white-centered hemorrhages: case report and review of literature", Indian J Ophthalmol, 60, pp.317~319 (2012)
- Hogan MJ, "The vitreous, its structure, and relation to the ciliary body and retina. Proctor award lecture", Invest Ophthalmol, 2, pp.418~445 (1963)
- Spencer LM, "Paravascular vitreoretinal attachments. Role in retinal tears", Arch Ophthalmol, 84, pp.557~564 (1970)
- Witmer MT, "Oral anticoagulation and the risk of vitreous hemorrhage and retinal tears in eyes with acute posterior vitreous detachment", Retina, 33, pp.621~626 (2013)
- Smiddy WE, "Pathogenesis of macular holes and therapeutic implications", Am J Ophthalmol, 137, pp.525~537 (2004)
- Kim HW, "Is macular hole a risk factor for retinal detachment?", Eye Sci, 30, pp.134~136 (2015)
- Kawahara S, "Intracellular events in retinal glial cells exposed to ICG and BBG", Invest Ophthalmol Vis Sci, 48, pp.4426~4432 (2007)
- Awad D, "Brilliant Blue G as protective agent against trypan blue toxicity in human retinal pigment epithelial cells in vitro", Graefes Arch Clin Exp Ophthalmol, 251, pp.1735~1740 (2013)
- Wang XH, "Inhibiting purinergic P2X7 receptors with the antagonist brilliant blue G is neuroprotective in an intranigral lipopolysaccharide animal model of Parkinson’s disease", Mol Med Rep, 15, pp.768~776 (2017)
- Remy M, "An in vivo evaluation of Brilliant Blue G in animals and humans", Br J Ophthalmol, 92, pp.1142~1147 (2008)
- Malerbi FK, "Subretinal brilliant blue G migration during internal limiting membrane peeling", Br J Ophthalmol, 93, pp.1687~ (2009)
- Almeida FP, "Accidental subretinal brilliant blue G migration during internal limiting membrane peeling surgery", JAMA Ophthalmol, 133, pp.85~88 (2015)
- Park YM, "Comparative analysis of brilliant blue G and an intracameral illuminator in assisting visualization of the anterior capsule in eyes with vitreous hemorrhage", J Cataract Refract Surg, 42, pp.1015~1021 (2016)
- Chauhan DS, "Papillofoveal traction in macular hole formation: the role of optical coherence tomography", Arch Ophthalmol, 118, pp.32~38 (2000)