Abstract
Background
During vitreoretinal surgery, vital dyes such as brilliant blue G (BBG) are used to visualize anatomical structures. By adding glucose to a concentration of 5%, many surgeons try to achieve a dye mixture heavier than water to facilitate staining of the ILM without preceding fluid–air exchange. However, the intraocular use of high glucose concentrations is critical. This study investigated the effect of 0.4 ml BBG (Brilliant Peel™ 0.25 mg/ml, Fluoron, Ulm, Germany) mixed with various glucose concentrations on the retina in an pseudo in vivo model
Methods
Bovine retinas were isolated and superfused with an oxygen saturated nutrient solution, and the electroretinogram (ERG) was recorded. BBG mixed with 0.05 ml/0.1 ml/0.15 ml glucose 40% was applied epiretinally. ERG recovery was monitored for 75 minutes. 1 mM aspartate was added to the nutrient solution to obtain a-waves.
Results
After application of BBG/0.05 ml 40% glucose, a non-significant decrease of the b-wave amplitude was recorded (11.2%). In contrast, higher glucose concentrations showed a significant decrease of the b-wave (23.40% at 0.1 ml glucose, 26% at 0.15 ml glucose). The a-wave amplitudes showed no significant change at the end of the washout for all concentrations.
Conclusions
The clinically used mixture of BBG and glucose seems to be safe up to a concentration of 5%. However, higher concentrations of glucose starting from 10% showed strong evidence of a toxic effect on the retinal function and should be avoided.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kelly NE, Wendel RT (1991) Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol 109:654–659
Park DW, Sipperley JO, Sneed SR (1999) Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology 106:1392–1397
Cherrick SR, Stein SW, Leevy CM, Davidson CS (1960) Indocyanine green: observations on its physical properties, plasma decay, and hepatic extraction. J Clin Invest 39:592–600
Da Mata AP, Burk SE, Riemann CD, Petersen MR, Nehemy MB, Augsburger JJ (2001) Indocyanine green-assisted peeling of the retinal internal limiting membrane during vitrectomy surgery for macular hole repair. Ophthalmology 108:1187–1192
Cheng SN, Yang TC, Ho JD, Hwang JF, Cheng CK (2005) Ocular toxicity of intravitreal indocyanine green. J Ocul Pharmacol Ther 21:85–93
Haritoglou C, Gandorfer A, Gass CA, Ulbig SM, MW KA (2002) Indocyanine green-assisted peeling of the internal limiting membrane in macular hole surgery affects visual outcome: a clinicopathologic correlation. Am J Ophthalmol 134:836–841
Kanda S, Uemura A, Yamashita T, Kita H, Yamakiri ST (2004) Visual field defects after intravitreous administration of indocyanine green in macular hole surgery. Arch Ophthalmol 122:1447–1451
Enaida H, Hisatomi T, Hata Y, Ueno A, Goto J, Yamada T, Kubota T, Ishibashi T (2006) Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling. Retina 26:631–636
Remy M, Thaler S, Schumann RG, May CA, Fiedorowicz M, Schuettauf F, Grueterich M, Priglinger SM, Nentwich MM, Kamplik A, Haritoglou C (2008) An in vivo evaluation of brilliant blue G in animals and humans. Br J Ophthalmol 92:1142–1147
Brown JP, Dorsky A, Enderlin FE, Hale RL, Wright VA, Parkinson TM (1980) Synthesis of 14 C-labelled FD&C Blue No. 1 (Brilliant Blue FCF) and its intestinal absorption and metabolic fate in rats Food. Cosmetic Toxicol 18:1–5
Kawahara S, Hata Y, Miura M, Kita T, Sengoku A, Nakao S, Mochizuki Y, Enaida H, Ueno A, Hafezi-Moghadam A, Ishbashi T (2007) Intracellular events in retinal glial cells exposed to ICG and BBG. Invest Ophthalmol Vis Sci 48:4426–4432
Lueke M, Januschowski K, Beutel J, Lueke C, Grisanti S, Peters S, Jaissle GB, Bartz-Schmidt KU, Szurman P (2008) Electrophysiological effects of brilliant blue G in the model of the isolated perfused vertebrate retina. Graefes Arch Clin Exp Ophthalmol 246:817–822
Lueke M, Weiergräber M, Brand C, Siapich SA, Banat M, Hescheler J, Lueke C, Schneidter T (2005) The isolated perfused bovine retina—a sensitive tool for pharmacological research on retinal function. Brain Res Brain Res Protoc 16:27–36
Sickel W (1965) Respiratory and electrical responses to light stimulation in the retina of the frog. Science 148:648–651
Henrich PB, Haritoglou C, Meyer P, Ferreira PR, Schoetzau A, Katamay R, Josifova T, Schneider U, Flammer J, Pringler S (2010) Anatomical and functional outcome in brilliant blue G assisted chromovitrectomy. Acta Ophthalmol 88(5):588–93
Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M (2009) Double staining with brilliant blue G and double peeling for epiretinal membranes. Ophthalmology 116:1370–1376
Stalmans P, Van Aken EH, Veckeneer M, Feron EJ, Stalmans I (2002) Indocyanine green on retinal pigment epithelium related to osmotic effects of the solvent. Am J Ophthalmol 134:282–285
Yuen D, Gonder J, Proulx A, Liu H, Hutnik C (2009) Comparison of the in vitro safety of intraocular dyes using two retinal cell lines: a focus on brilliant blue G and indocyanine green. Am J Ophthalmol 147:251–259
Chandrasekaran K, Swaminathan K, Chatterjee S, Dey A (2010) Apoptosis in HepG2 cells exposed to high glucose. Toxicol In Vitro 24:387–396
Lehnen-Beyel I, Groot HD, Rauen U (2002) Enhancement of iron toxicity in L929 cells by D-glucose: accelerated(re-)reduction. Biochem J 368:517–526
Van Bergen NJ, Wood JP, Chidlow G, Trounce IA, Casson RJ, Ju WK, Weinreb RN, Crowston JG (2009) Recharacterization of the RGC-5 retinal ganglion cell line. Invest Ophthalmol Vis Sci 50:4267–4272
Graymore CN (1970) Metabolic survival of the isolated retina. Br Med Bull 26:130–133
Sickel W (1969) Energy metabolism of the retina. Exp Eye Res 8:252
Marmor MF (1979) Retinal detachment from hyperosmotic intravitreal injection. Invest Ophthalmol Vis Sci 18:1237–1244
Marmor MF, Martin LJ, Tharpe S (1980) Osmotically induced retinal detachment in the rabbit and primate. Electron miscoscopy of the pigment epithelium. Invest Ophthalmol Vis 19:1016–1029
Acknowledgement
We would like to thank Regina Hofer for her untiring support
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors have full control of all primary data, and they agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review their data upon request
Disclosure
K. Januschowski, none; S. Mueller, none; M. S. Spitzer, none; M. Lueke, none; K.U. Bartz-Schmidt , none; P. Szurman, none.
Rights and permissions
About this article
Cite this article
Januschowski, K., Mueller, S., Spitzer, M.S. et al. The effects of the intraocular dye brilliant blue G (BBG) mixed with varying concentrations of glucose on retinal function in an isolated perfused vertebrate retina. Graefes Arch Clin Exp Ophthalmol 249, 483–489 (2011). https://doi.org/10.1007/s00417-010-1508-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-010-1508-5