Muhammad Usman Saeed1, Heinrich Heimann. 1. Vitreo-Retinal Department, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. musmansaeed@aol.com
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.
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.
Authors: Nicholas E Engelbrecht; Jiong Freeman; Paul Sternberg; Thomas M Aaberg; Thomas M Aaberg; Daniel F Martin; Brian D Sippy Journal: Am J Ophthalmol Date: 2002-01 Impact factor: 5.258
Authors: L Kodjikian; T Richter; M Halberstadt; F Beby; F Flueckiger; M Boehnke; J G Garweg Journal: Graefes Arch Clin Exp Ophthalmol Date: 2005-04-15 Impact factor: 3.117
Authors: Fernando M Penha; Mauricio Maia; Michel Eid Farah; André H Príncipe; Edna H Freymüller; André Maia; Octaviano Magalhães; Ricardo L Smith Journal: Ophthalmology Date: 2007-02-08 Impact factor: 12.079
Authors: B J Putting; R C Zweypfenning; G F Vrensen; J A Oosterhuis; J A van Best Journal: Invest Ophthalmol Vis Sci Date: 1992-11 Impact factor: 4.799
Authors: Nicolás Rivera-Valdivia; Hiroshi Maeda-Yasunaga; Pablo Cabal-López; Carlos Salgado-Cerrate; Carlos Abdala-Caballero Journal: Rom J Ophthalmol Date: 2022 Jan-Mar