Internal limiting membrane staining
Internal limiting membrane staining
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DOI：
10.1111/j.1755-3768.2009.3413.x
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发表时间：
2009-09
影响因子：
3.4
通讯作者：
J. Katsimpris
中科院分区：
文献类型：
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作者：
J. Katsimpris
目的探讨内界膜染色治疗特发性黄斑裂孔的方法。方法采用医学主题词检索MEDLINE数据库，检索与ILM染色、黄斑裂孔手术相关的关键词。结果内界膜切除率与手术闭合率密切相关。然而，由于ILM可见性差，手术切除ILM非常困难，并造成严重的并发症。为了获得更好的ILM可见性，已经开发了一些使用特定染料的特殊技术，例如台盼蓝（TB）、吲哚菁绿色（ICG）、Infracyanine绿色或曲安奈德（TA）。一次手术的解剖成功率增加了（>90%），但是，出现了对毒性的担忧。与未使用ICG的患者相比，ICG辅助ILM剥离的患者似乎具有较低的视力恢复。已显示ICG浓度<0.5mg/mL在RPE细胞培养物中是无毒的。碱性花青绿色是一种类似的分子，不含碘，与ICG相比，不太可能对PRE细胞诱导渗透压相关的毒性作用。它还与锥虫（TB）联合用于ILM染色。TB是第二代活体染料，其直接染色视网膜前膜（ERM），并且在较小程度上染色ILM。因此，TB对于黄斑裂孔和黄斑皱褶手术都是有用的。TA也可用于帮助突出ILM，尽管它不是染料。它确实附着在后玻璃体上，使得ILM的检测更容易。结论本文综述了近年来ILM染色技术的发展。与结核病相比，ICG的毒性更大。对于TA的长期影响尚未得到充分研究。
Purpose To describe the different modalities of internal limiting membrane (ILM) staining for the treatment of idiopathic macular hole (IMH). Methods Search of the MEDLINE database by using Medical Subject Heading search terms and key words related to ILM staining, macular hole surgery. Results ILM removal has been closely related with increased closure rates. However, because of poor ILM visibility the surgical removal of ILM is very difficult and poses serious complications. To obtain better visibility of ILM some special techniques have been developed using specific dyes such as, trypan blue (TB), indocyanine green (ICG), infracyanine green or triamsinolone acetonide(TA). Anatomic success rates with one surgery have increased (>90%) however, concern for toxicity has emerged. Patients with ICG-assisted ILM peeling appear to have a depressed recovery of visual acuity compared to those not using ICG. Concentrations of ICG that are <0.5 mg/mL have been shown to be non-toxic in cultures of RPE cells. Infracyanine green is a similar molecule that does not contain iodine and is less likely to induce osmolarity related toxic effects on the PRE cells when compared to ICG. It has been used also for ILM staining in combination with trypan(TB). TB is a second generation vital dye that stains epiretinal membranes (ERMs) directly and ILM to a lesser extent. Thus TB is useful for both macular hole and macular pucker surgery. TA may be also used to help highlight the ILM, although it is not a dye. It does adhere to the posterior hyaloid, making the detection of ILM easier. Conclusion This review largely reflects the great advent of different techniques for ILM staining. The use of ICG is more toxic when compared with TB. For TA long-term effects have not been well studied.