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International Ophthalmology

, Volume 29, Issue 4, pp 239–241 | Cite as

Atrophy of the retinal pigment epithelium following vitrectomy with trypan blue

  • Muhammad Usman SaeedEmail author
  • Heinrich Heimann
Case Report

Abstract

Purpose To report a case of possible trypan blue retinotoxicity after macular hole surgery. Methods Retrospective review of case notes and follow-up in one patient with unusual appearance of the fundus after macular hole surgery with trypan blue. Results A 69-year-old female presented to our eye clinic with a complaint of loss of vision over the last 6 months. Examination showed a full-thickness macular hole in the right eye. She underwent right pars plana vitrectomy with internal limiting peel assisted by trypan blue. Surgery was routine with no difficulty during surgical peel of the inner limiting membrane. Two weeks postoperatively, increased pigmentation and atrophy at the level of the retinal pigment epithelium (RPE) was noted temporal to the fovea. The macular hole appeared closed. Fundus fluorescein angiography showed this to be a lesion with characteristics of RPE atrophy. Conclusion In the absence of excessive peroperative surgical trauma to the region of the scar, the retinal changes may be secondary to possible toxicity due to trypan blue stain, light toxicity or a combination of both.

Keywords

Trypan blue Stain Retina Toxicity 

Notes

Acknowledgements

The authors wish to thank Bill Hooley, Ophthalmic photographer, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool.

References

  1. 1.
    Kodjikian L, Richter T, Halberstadt M et al (2005) Toxic effects of indocyanine green, infracyanine green, and trypan blue on the human retinal pigmented epithelium Graefes. Arch Clin Exp Ophthalmol 243(9):917–925CrossRefGoogle Scholar
  2. 2.
    Penha FM, Maia M, Eid Farah M et al (2007) Effects of subretinal injections of indocyanine green, trypan blue, and glucose in rabbit eyes. Ophthalmology 114(5):899–908PubMedCrossRefGoogle Scholar
  3. 3.
    Maia M, Penha F, Rodrigues EB et al (2007) Effects of subretinal injection of patent blue and trypan blue in rabbits. Curr Eye Res 32(4):309–317PubMedCrossRefGoogle Scholar
  4. 4.
    Balayre S, Boissonnot M, Paquereau J et al (2005) Evaluation of trypan blue toxicity in idiopathic epiretinal membrane surgery with macular function test using multifocal electroretinography: seven prospective case studies. J Fr Ophtalmol 28(2):169–176PubMedCrossRefGoogle Scholar
  5. 5.
    Engelbrecht NE, Freeman J, Sternberg P Jr et al (2002) Retinal pigment epithelial changes after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 133(1):89–94PubMedCrossRefGoogle Scholar
  6. 6.
    Putting BJ, Zweypfenning RC, Vrensen GF et al (1992) Blood-retinal barrier dysfunction at the pigment epithelium induced by blue light. Invest Ophthalmol Vis Sci 33:3385–3393PubMedGoogle Scholar
  7. 7.
    Fuller D, Machemer R, Knighton RW (1978) Retinal damage produced by intraocular fiber optic light. Am J Ophthalmol 85(4):519–537PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  1. 1.Vitreo-Retinal Department, St Paul’s Eye UnitRoyal Liverpool University HospitalLiverpoolUK

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