Skip to main content

Inner retinal structure and visual function after idiopathic epiretinal membrane surgery with and without brilliant blue G

A Correction to this article was published on 13 August 2021

This article has been updated

Abstract

Purpose

Vital dyes are frequently used to visualize the internal limiting membrane (ILM) of the neuroretina. This study evaluated and compared the microstructure of the inner retina and visual function with and without brilliant blue G (BBG) staining for ILM peeling during idiopathic epiretinal membrane (ERM) surgery.

Study design

Retrospective, consecutive, interventional case series.

Methods

Fifty-five patients (55 eyes) with ERM underwent ILM peeling without dyes (non-dye group) and 55 patients (55 eyes) underwent ILM peeling with BBG staining (BBG group). The logMAR visual acuity (VA) and ganglion cell complex (GCC) thickness were measured using optical coherence tomography at baseline and 12 months after surgery.

Results

LogMAR VA improved significantly in both groups at 12 months and the BBG group tended to be better than the non-dye group but with no significant difference between the groups (unpaired t-test, P = 0.490). The average GCC thickness significantly decreased in both groups; however, there was no difference in the rates of change in GCC thickness between the groups. The ratio of GCC thickness to total retinal thickness (%) was significantly higher in the BBG group in the superior quadrant at 12 months postoperatively (P = 0.010).

Conclusion

BBG-assisted ERM surgery resulted in better visual improvement and fewer structural changes in the inner retinal layers. BBG-assisted ILM peeling is safe both functionally and anatomically.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Change history

References

  1. 1.

    Kwok AK, Lai TY, Yuen KS. Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Exp Ophthalmol. 2005;33:379–85.

    Article  Google Scholar 

  2. 2.

    Sandali O, El Sanharawi M, Basli E, Bonnel S, Lecuen N, Barale PO, et al. Epiretinal membrane recurrence: incidence, characteristics, evolution, and preventive and risk factors. Retina. 2013;33:2032–8.

    Article  Google Scholar 

  3. 3.

    Beyazyildiz Ö, Tirhiş MH, Hekimoğlu ER, Beyazyildiz E, Kaymaz F, Yilmazbaş P, et al. Histopathological analysis of internal limiting membrane surgically peeled from eyes with epiretinal membrane. Curr Eye Res. 2016;41:258–65.

    CAS  Article  Google Scholar 

  4. 4.

    Sippy BD, Engelbrecht NE, Hubbard GB, Moriarty SE, Jiang S, Aaberg TM Jr, et al. Indocyanine green effect on cultured human retinal pigment epithelial cells: implication for macular hole surgery. Am J Ophthalmol. 2001;132:433–5.

    CAS  Article  Google Scholar 

  5. 5.

    Enaida H, Sakamoto T, Hisatomi T, Goto Y, Ishibashi T. Morphological and functional damage of the retina caused by intravitreous indocyanine green in rat eyes. Graefes Arch Clin Exp Ophthalmol. 2002;240:209–13.

    Article  Google Scholar 

  6. 6.

    Enaida H, Hisatomi T, Goto Y, Hata Y, Ueno A, Miura M, et al. Preclinical investigation of internal limiting membrane staining and peeling using intravitreal brilliant blue G. Retina. 2006;26:623–30.

    Article  Google Scholar 

  7. 7.

    Ueno A, Hisatomi T, Enaida H, Kagimoto T, Mochizuki Y, Goto Y, et al. Biocompatibility of brilliant blue G in a rat model of subretinal injection. Retina. 2007;27:499–504.

    Article  Google Scholar 

  8. 8.

    Notomi S, Hisatomi T, Kanemaru T, Takeda A, Ikeda Y, Enaida H, et al. Critical involvement of extracellular ATP acting on P2RX7 purinergic receptors in photoreceptor cell death. Am J Pathol. 2011;179:2798–809.

    CAS  Article  Google Scholar 

  9. 9.

    Kakurai K, Sugiyama T, Kurimoto T, Oku H, Ikeda T. Involvement of P2X(7) receptors in retinal ganglion cell death after optic nerve crush injury in rats. Neurosci Lett. 2013;534:237–41.

    CAS  Article  Google Scholar 

  10. 10.

    Kumagai K, Hangai M, Ogino N. Progressive thinning of regional macular thickness after epiretinal membrane surgery. Invest Ophthalmol Vis Sci. 2015;56:7236–42.

    Article  Google Scholar 

  11. 11.

    Pierro L, Iuliano L, Gagliardi M, Codenotti M, Ambrosi A, Bandello F. Role of ganglion cell complex in visual recovery following surgical internal limiting membrane peeling. Graefes Arch Clin Exp Ophthalmol. 2015;253:37–45.

    Article  Google Scholar 

  12. 12.

    Terashima H, Okamoto F, Hasebe H, Matsuoka N, Fukuchi T. Vitrectomy for epiretinal membranes: ganglion cell features correlate with visual function outcomes. Ophthalmol Retina. 2018;2:1152–62.

    Article  Google Scholar 

  13. 13.

    Baba T, Sato E, Oshitari T, Yamamoto S. Regional reduction of ganglion cell complex after vitrectomy with internal limiting membrane peeling for idiopathic macular hole. J Ophthalmol. 2014;2014:372589.

    Article  Google Scholar 

  14. 14.

    Sabater AL, Velázquez-Villoria Á, Zapata MA, Figueroa MS, Suárez-Leoz M, Arrevola L, et al. Evaluation of macular retinal ganglion cell-inner plexiform layer thickness after vitrectomy with internal limiting membrane peeling for idiopathic macular holes. Biomed Res Int. 2014;2014:458631.

  15. 15.

    Sevim MS, Sanisoglu H. Analysis of retinal ganglion cell complex thickness after Brilliant Blue-assisted vitrectomy for idiopathic macular holes. Curr Eye Res. 2013;38:180–4.

    Article  Google Scholar 

  16. 16.

    Tadayoni R, Svorenova I, Erginay A, Gaudric A, Massin P. Decreased retinal sensitivity after internal limiting membrane peeling for macular hole surgery. Br J Ophthalmol. 2012;96:1513–6.

    Article  Google Scholar 

  17. 17.

    Ishida M, Ichikawa Y, Higashida R, Tsutsumi Y, Ishikawa A, Imamura Y. Retinal displacement toward optic disc after internal limiting membrane peeling for idiopathic macular hole. Am J Ophthalmol. 2014;157:971–7.

    Article  Google Scholar 

  18. 18.

    Takeyama A, Kita Y, Kita R, Tomita G. Influence of axial length on ganglion cell complex (GCC) thickness and on GCC thickness to retinal thickness ratios in young adults. Jpn J Ophthalmol. 2014;58:86–93.

    Article  Google Scholar 

  19. 19.

    Wolf S, Schnurbusch U, Wiedemann P, Grosche J, Reichenbach A, Wolburg H. Peeling of the basal membrane in the human retina: ultrastructural effects. Ophthalmology. 2004;111:238–43.

    Article  Google Scholar 

  20. 20.

    Pichi F, Lembo A, Morara M, Veronese C, Alkabes M, Nucci P, et al. Early and late inner retinal changes after inner limiting membrane peeling. Int Ophthalmol. 2014;34:437–46.

    Article  Google Scholar 

  21. 21.

    Lee SB, Shin YI, Jo YJ, Kim JY. Longitudinal changes in retinal nerve fiber layer thickness after vitrectomy for epiretinal membrane. Invest Ophthalmol Vis Sci. 2014;55:6607–11.

    Article  Google Scholar 

  22. 22.

    Seo KH, Yu S, Kwak HW. Topographic changes in macular ganglion cell–inner plexiform layer thickness after vitrectomy with indocyanine green–guided internal limiting membrane peeling for idiopathic macular hole. Retina. 2015;35:1828–35.

    Article  Google Scholar 

  23. 23.

    Kumagai K, Ogino N, Furukawa M, Hangai M, Kazama S, Nishigaki S, et al. Retinal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane. Clin Ophthalmol. 2012;6:679–88.

    Article  Google Scholar 

  24. 24.

    Ambiya V, Goud A, Khodani M, Chhablani J. Inner retinal thinning after Brilliant Blue G-assisted internal limiting membrane peeling for vitreoretinal interface disorders. Int Ophthalmol. 2017;37:401–8.

    Article  Google Scholar 

  25. 25.

    Govetto A, Lalane RA III, Sarraf D, Figueroa MS, Hubschman JP. Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme. Am J Ophthalmol. 2017;175:99–113.

    Article  Google Scholar 

  26. 26.

    Kita Y, Kita R, Takeyama A, Takagi S, Nishimura C, Tomita G. Ability of optical coherence tomography-determined ganglion cell complex thickness to total retinal thickness ratio to diagnose glaucoma. J Glaucoma. 2013;22:757–62.

    Article  Google Scholar 

  27. 27.

    Remy M, Thaler S, Schumann RG, May CA, Fiedorowicz M, Schuettauf F, et al. An in vivo evaluation of Brilliant Blue G in animals and humans. Br J Ophthalmol. 2008;92:1142–7.

    CAS  Article  Google Scholar 

  28. 28.

    Baba T, Hagiwara A, Sato E, Arai M, Oshitari T, Yamamoto S. Comparison of vitrectomy with brilliant blue G or indocyanine green on retinal microstructure and function of eyes with macular hole. Ophthalmology. 2012;119:2609–15.

    Article  Google Scholar 

  29. 29.

    Tsuchiya S, Higashide T, Sugiyama K. Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes. PloS ONE. 2017;12:e0177526.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Mari S. Oba, Department of Medical Statistics Faculty of Medicine, Toho University, for her assistance with the statistical analysis. The authors thank the certified orthoptists Kazue Saito, Megumi Tamai, Moe Mita, and Kyoko Araki for their contribution to the spectral-domain optical coherence tomography image acquisition and data collection.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Asuka Takeyama.

Ethics declarations

Conflicts of interest

A. Takeyama, None; Y. Imamura, None; M. Shibata, None; Y. Komiya, None; M. Ishida, None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding author: Asuka Takeyama

About this article

Verify currency and authenticity via CrossMark

Cite this article

Takeyama, A., Imamura, Y., Shibata, M. et al. Inner retinal structure and visual function after idiopathic epiretinal membrane surgery with and without brilliant blue G. Jpn J Ophthalmol 65, 689–697 (2021). https://doi.org/10.1007/s10384-021-00851-7

Download citation

Keywords

  • Epiretinal membrane
  • Brilliant blue G
  • Internal limiting membrane peeling
  • Ganglion cell complex
  • Vitrectomy