Effekt von Chromovitrektomiefarbstoffen mit Lutein auf die verbesserte Darstellung von epiretinalen Pathologien im intraoperativen OCT

Zusammenfassung

Hintergrund Epiretinale Membranen können zu Metamorphopsien und Sehverschlechterung führen. Der therapeutische „Goldstandard“ ist die Vitrektomie mit Membrane Peeling, die normalerweise mit Chromovitrektomiefarbstoffen durchgeführt wird. Ziel unserer Studie war es, zu untersuchen, ob Chromovitrektomiefarbstoffe mit Lutein die Darstellung von epiretinalem Gewebe in der intraoperativen optischen Kohärenztomografie (iOCT) verbessern können.

Patienten und Methoden Eine prospektive Studie mit 20 Augen von 20 Patienten, die aufgrund einer idiopathischen epiretinalen Gliose zur Operation geplant waren. Bei allen Patienten wurde eine 23-G-Pars-plana-Vitrektomie mit Membrane Peeling unter iOCT-Assistenz durchgeführt. Die Membranen wurden mit einem Chromovitrektomiefarbstoff, der Trypanblau, „brilliant blue G“ und Lutein enthielt (Tripledyne und Dualdyne, beide: Kemin Industries Inc., USA) vor dem Peeling gefärbt.

Ergebnisse Bei allen Patienten (n = 20) war die Färbung der Membranen gut; kristalline Luteinpartikel konnten im iOCT gut dargestellt werden, verglichen zu gelöstem Lutein, das epiretinales Gewebe im iOCT nicht verbessert darstellen konnte.

Schlussfolgerung Die Zugabe von Lutein zu Chromovitrektomiefarbstoffen ermöglicht bei Verwendung von kristallinem Lutein eine verbesserte Darstellung von epiretinalen Membranen im iOCT.

Abstract

Background Epiretinal membranes are a disorder leading to metamorphopsia and loss in visual function. The gold standard in therapy is vitrectomy with membrane peeling, usually performed with chromovitrectomy. The aim of this study was to examine whether dyes containing lutein are capable of enhancing visualization of epiretinal tissue in intraoperative optical coherence tomography (iOCT).

Patients and Methods This was a prospective study that included 20 eyes of 20 patients with idiopathic epiretinal membranes scheduled for surgery. 23 G pars plana vitrectomy with intraoperative assistance of iOCT was performed in all cases. Staining of epiretinal membranes was performed with dyes containing trypan blue, brilliant blue G and lutein (tripledyne and dualdyne, both Kemin Industries Inc., USA).

Results In all patients (n = 20), staining of epiretinal tissue was good, and crystalline lutein particles could be well depicted in iOCT compared to soluble lutein that does not enhance visualisation of epiretinal tissue in iOCT.

Conclusions The addition of lutein to commonly used dye formulations offers good staining properties and, in case of crystalline lutein, also enhances epiretinal tissue in iOCT.

Schlüsselwörter

Luteinfarbstoffe - Vitrektomie mit Membrane Peeling - epiretinale Membranen

Key words

dyes containing lutein - vitrectomy with membrane peeling - epiretinal membranes

Publication History

Received: 25 July 2019

Accepted: 16 September 2019

Article published online:
26 November 2019

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