Retinal damage from indocyanine green in experimental macular surgery
Retinal damage from indocyanine green in experimental macular surgery
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DOI：
10.1167/iovs.02-0545
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发表时间：
2003-01-01
影响因子：
4.4
通讯作者：
Kampik, A
中科院分区：
文献类型：
--
作者：
Gandorfer, A;Haritoglou, C;Kampik, A
目的。先前的工作表明，吲哚菁绿（ICG）辅助的内界膜（ILM）剥离可能会导致视网膜损伤。在这项研究中，假设了 ICG 在玻璃体视网膜界面处的毒性和光动力效应。将 10 只人类供体眼睛切成两半，并将 0.05 mL 0.05% ICG 倒在 8 只眼睛的环钻黄斑上。一分钟后，通过冲洗将染料排出。用 380 至 760、380 至 620 或 620 至 760 am 的波长照射两只眼睛的黄斑 3 分钟。两只眼睛仅接受 ICG 治疗，两只眼睛仅进行照明。对来自黄斑和未经处理的视网膜的视网膜样本进行光学和电子显微镜处理。测量了光源的辐照度和ICG的吸收特性。结果。将 ICG 染色的 ILM 暴露在超过 620 nm 的波长下会导致内部视网膜严重损伤，包括 ILM 损失、细胞解体和细胞质破碎。单独的 ICG 染色或与 380 至 620 nm 波长组合的 ICG 染色显示 Muller 细胞破裂，ILM 脱离，但没有其他细胞解体。仅接受照明的眼睛未显示任何异常。结论。 ICG 的光谱吸收特性可以解释 ICG 在玻璃体视网膜界面处可能的光动力效应。即使没有有意剥离膜，单独的 ICG 也会诱导 ILM 脱离和 Muller 细胞破裂。据推测，玻璃体黄斑界面处染料的积累可能会提高视网膜处 ICG 的浓度和渗透压，使其超出玻璃体内值和临界限值。
PURPOSE. Previous work has shown that indocyanine green (ICG)-assisted peeling of the inner limiting membrane (ILM) may cause retinal damage. In this study, a toxic and a photodynamic effect of ICG at the vitreoretinal interface was assumed.METHODS. Ten human donor eyes were hemisected, and 0.05 mL of 0.05% ICG was poured over the trephined macula in eight eyes. After I minute, the dye was drained by irrigation. The macula in each of two eyes was illuminated for 3 minutes with wavelengths of 380 to 760, 380 to 620, or 620 to 760 am. Two eyes were treated with ICG only, and two eyes were illuminated only. Retinal specimens from the macula and the untreated retina were processed for light and electron microscopy. The irradiance of the light source and the absorption properties of ICG were measured.RESULTS. Exposure of the ICG-stained ILM to wavelengths beyond 620 nm resulted in severe damage to the inner retina, including loss of ILM, cellular disorganization, and fragmentation of the cytoplasm. ICG staining alone or in combination with wavelengths of 380 to 620 nm disclosed rupture of Muller cells with detachment of the ILM, but no other cellular disorganization. Eyes subjected to illumination only showed no abnormalities.CONCLUSIONS. The spectral absorption properties of ICG may account for a possible photodynamic effect of ICG at the vitreoretinal interface. ICG alone induces ILM detachment and disruption of Muller cells even without intentional peeling of the membrane. It is assumed that accumulation of the dye at the vitreomacular interface may enhance the concentration and osmolarity of ICG at the retina beyond intravitreous values and critical limits.