1
|
Bergamo VC, Caiado RR, Maia A, Magalhães O, Moraes NSB, Rodrigues EB, Farah ME, Maia M. Role of Vital Dyes in Chromovitrectomy. Asia Pac J Ophthalmol (Phila) 2020; 10:26-38. [PMID: 33252365 DOI: 10.1097/apo.0000000000000344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Chromovitrectomy, the intraocular application of dyes to assist visualization of preretinal tissues during vitreoretinal surgery, was introduced to avoid ocular complications related to internal limiting membrane peeling, inadequate removal of the vitreous, and incomplete removal of epiretinal membranes. Since 2000, chromovitrectomy has become a popular approach among vitreoretinal specialists. The first vital dye used in chromovitrectomy, indocyanine green, facilitated identification of the fine and transparent internal limiting membrane. Following indocyanine green, trypan blue was introduced to identify epiretinal membranes, and triamcinolone acetonide stained the vitreous well. Recently, additional natural dyes such as lutein and anthocyanin from the açaí fruit have been proposed for intraocular application during vitrectomy. The main goal of this review was to study the role of vital stains in chromovitrectomy and report the latest findings in the literature.
Collapse
Affiliation(s)
- Vinicius C Bergamo
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Rafael R Caiado
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - André Maia
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Octaviano Magalhães
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Nilva S B Moraes
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Eduardo B Rodrigues
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
- Department of Ophthalmology, SSM Health Saint Louis University Hospital, Saint Louis University, St. Louis, Missouri, United States
| | - Michel E Farah
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Mauricio Maia
- Retina Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Bracha P, Ciulla TA, Baumal CR. Vital Dyes in Vitreomacular Surgery. Ophthalmic Surg Lasers Imaging Retina 2019; 49:788-798. [PMID: 30395665 DOI: 10.3928/23258160-20181002-07] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 09/09/2018] [Indexed: 11/20/2022]
Abstract
Vital dyes contain complex molecules with chromophores that stain living tissues and have greatly enhanced identification and removal of transparent vitreoretinal tissues during surgery. Several "chromovitrectomy" dyes are frequently used by vitreoretinal specialists, including indocyanine green, trypan blue, brilliant blue G, and triamcinolone acetonide; other dyes are also under investigation. Trypan Blue was approved by the U.S. Food and Drug Administration (FDA) for epiretinal membrane removal, and preservative-free triamcinolone acetonide was approved by the FDA for intraocular use. However, currently available chromovitrectomy dyes have their limitations, and of particular concern for some of them is the possibility for acute and chronic toxicity to the neurosensory retina and retinal pigmented epithelium. The potentially irreversible acute toxicity and other limitations, such as lack of long-term safety profiles, highlight the need for further advancements. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:788-798.].
Collapse
|
3
|
Caiado RR, Peris C, Rodrigues EB, Farah ME, Maia A, Magalhães O, Novais E, Lima-Filho AS, Maia M. A new dye based on anthocyanins from the acai fruit (Euterpe oleracea) for chromovitrectomy in humans: clinical trial results. Graefes Arch Clin Exp Ophthalmol 2019; 257:517-528. [PMID: 30607553 DOI: 10.1007/s00417-018-04204-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/20/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To test the applicability of the acai dye at a 25% concentration for identifying the posterior hyaloids and internal limiting membranes (ILMs) during pars plana vitrectomy (PPV) in human eyes with macular holes (MHs). METHODS This study included 25 patients with chronic idiopathic MHs. The exclusion criteria included glaucoma, previous significant ocular conditions, and previous ocular surgeries except uncomplicated cataract. Ten surgeons performed 23-gauge four-port PPV, phacoemulsification, posterior hyaloid detachment, ILM peeling guided by dye staining, and perfluoropropane injection. The patients remained prone for 5 days postoperatively. The patients were evaluated postoperatively after 1, 30, and 180 days. The surgeons completed a questionnaire regarding the dye's staining abilities. RESULTS The posterior hyaloids and ILMs stained purple in all eyes. The final best-corrected visual acuity improved significantly (p < 0.001) from preoperatively (1.37 ± 0.29) to 180 days postoperatively (1.05 ± 0.43). The MHs closed in 76% of eyes. CONCLUSION The acai dye at a 25% concentration identified posterior hyaloids and ILMs during PPVs in humans. Dye toxicity was unlikely.
Collapse
Affiliation(s)
- Rafael R Caiado
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Cristiane Peris
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Eduardo B Rodrigues
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Michel Eid Farah
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - André Maia
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Octaviano Magalhães
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Eduardo Novais
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil
| | - Acácio Souza Lima-Filho
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil.,Ophthalmos Pharmaceutical Industry, São Paulo, Brazil
| | - Mauricio Maia
- Vision Institute, Department of Ophthalmology, Federal University of São Paulo, 781, Pedro de Toledo Street, 2nd floor, São Paulo, 04039-032, Brazil. .,Brazilian Institute of Fight Against Blindness, Assis/Presidente Prudente, São Paulo, Brazil.
| |
Collapse
|
4
|
Analysis of Anthocyanins Extracted from the Acai Fruit ( Euterpe oleracea): A Potential Novel Vital Dye for Chromovitrectomy. J Ophthalmol 2018; 2018:6830835. [PMID: 30116632 PMCID: PMC6079485 DOI: 10.1155/2018/6830835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To classify and quantify anthocyanins in a vital dye extracted from the acai fruit (Euterpe oleracea), adjust pH and osmolarity, and perform lyophilization to develop a new chromovitrectomy dye. Methods Three dye concentrations 10%, 25%, and 35% (equivalent to 100, 250, and 350 mg of lyophilized acai fruit pulp extract samples) were evaluated when diluted in 1 ml of phosphate-buffered solution (pH 7 and 300 mOsm). The dye was analyzed by mass spectrometry and high-performance liquid chromatography (HPLC) to identify and quantify anthocyanins molecules. Results The pH and osmolarity correction and lyophilization were performed without damaging the anthocyanin molecular structure. Mass spectrometry confirmed the presence of five anthocyanins in the three concentrations of the dye. Cyanidin-3-O-glucoside was the major anthocyanin found. HPLC showed that the concentration of anthocyanin was similar, independent of the dye concentration tested. Conclusions Lyophilization and the correction of pH and osmolarity (7.00 and 300 mOsm, resp.) were performed successfully. Five anthocyanins are present in the dye from the acai fruit. The major anthocyanin is cyanidin-3-O-glucoside. Independent of the dye concentration tested, the anthocyanin concentration was similar. Standardized chemical characteristics of this new dye may allow its use during chromovitrectomy in humans.
Collapse
|
5
|
Chuang LH, Wu AL, Wang NK, Chen KJ, Liu L, Hwang YS, Yeung L, Wu WC, Lai CC. The intraocular staining potential of anthocyanins and their retinal biocompatibility: a preclinical study. Cutan Ocul Toxicol 2018; 37:359-366. [PMID: 29742931 DOI: 10.1080/15569527.2018.1471698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To perform preclinical studies to determine the efficacy and safety of anthocyanins as stains for the internal limiting membrane (ILM) of the eye. MATERIALS AND METHODS Cyanidin (Cya), delphinidin (Del), luteolinidin (Lut), peonidin (Peo) and pelargonidin (Pel) were evaluated. These natural dyes were used to stain the lens capsule and ILM of pig eyes. The effects of these dyes on retinal cell viability was determined using a water-soluble tetrazolium salt assay, and oxidative stress was measured in vitro. Histopathology, in situ TUNEL labelling, transmission electronic microscopy (TEM), and electroretinography (ERG) were performed on rats following the intravitreal and subretinal injection of the neuroprotective dyes. RESULTS All anthocyanins stained the lens capsule and ILM of the pigs at a concentration of 1 mg/ml. Del, Lut and Peo were non-toxic and produced survival rates in the ARPE19 and RGC5 cells that were similar to those in control cells. We treated eyes with H2O2 and three dyes (Del, Lut, and Peo) to explore the possible neuroprotective effects and observed significantly higher survival rates in the ARPE19 cells treated with Del, Lut or Peo and the RGC5 cells treated with Lut or Peo than those in the control cells. Three dyes were intravitreally and subretinally injected into rats in vivo, and the histology showed mildly disorganized retinal cell layers. TUNEL staining and TEM examinations did not reveal additional toxic effects. Rat ERGs were not altered after intravitreal injections. CONCLUSIONS This preclinical study, Del, Lut, and Peo show potential as staining agents and warrant further investigation as vital dyes.
Collapse
Affiliation(s)
- Lan-Hsin Chuang
- a Department of Ophthalmology , Chang Gung Memorial Hospital , Keelung , Taiwan.,b College of Medicine , Chang Gung University , Taoyuan , Taiwan
| | - An-Lun Wu
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Nan-Kai Wang
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.,d Department of Ophthalmology, Edward S. Harkness Eye Institute , Columbia University , New York , NY , USA
| | - Kuan-Jen Chen
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Laura Liu
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Yih-Shiou Hwang
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Ling Yeung
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Wei-Chi Wu
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| | - Chi-Chun Lai
- b College of Medicine , Chang Gung University , Taoyuan , Taiwan.,c Department of Ophthalmology , Chang Gung Memorial Hospital , Taoyuan , Taiwan
| |
Collapse
|
6
|
Caiado RR, Peris CS, Lima-Filho AAS, Urushima JGP, Novais E, Badaró E, Maia A, Sinigaglia-Coimbra R, Watanabe SES, Rodrigues EB, Farah ME, Maia M. Retinal Toxicity of Acai Fruit (Euterpe Oleracea) Dye Concentrations in Rabbits: Basic Principles of a New Dye for Chromovitrectomy in Humans. Curr Eye Res 2017; 42:1185-1193. [PMID: 28494212 DOI: 10.1080/02713683.2017.1297995] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Evaluate toxicity of acai fruit (Euterpe oleracea) dye concentrations in a rabbit model. METHODS Rabbits were injected intravitreously with 10%, 25%, and 35% acai dye concentrations. Control eyes received balanced salt solution (BSS). Electroretinogram (ERG), fundus imaging, fluorescein angiography (FA), optical coherence tomography (OCT), and light and transmission electron microscopy (LM/TEM) were performed. RESULTS Fundus imaging showed increased vitreous opacity with increased dye concentrations. FA and OCT showed normality with all concentrations. Comparisons between BSS and dye concentrations were analyzed using Kruskal-Wallis and Mood's median test (p < 0.05). At 24 h, ERGs showed reduced amplitudes from baseline in all eyes. Median b-wave amplitudes nonsignificantly decreased and latency increased with 10% and 25%; findings were significant (p < 0.05) for 35%. LM and TEM showed no abnormalities for 10% and 25%. With 35%, TEM showed ganglion cell edema at 24 h that resolved after 7 days. Vacuolization, multilamellar bodies, and nerve bundle damage occurred at 24 h/7 days in the inner nuclear layer. Mitochondrial cristae disruption occurred in the inner photoreceptor segment at 24 h that decreased by 7 days. CONCLUSION Ten and twenty-five percent concentrations were safe and may improve identification of the posterior hyaloid and internal limiting membrane during chromovitrectomy in humans.
Collapse
Affiliation(s)
- Rafael R Caiado
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Cristiane S Peris
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | | | | | - Eduardo Novais
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Emmerson Badaró
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - André Maia
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Rita Sinigaglia-Coimbra
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil.,b Electron Microscopy Center (CEME), Federal University of São Paulo , São Paulo , Brazil
| | - Sung Eun S Watanabe
- c Brazilian Institute of Fighting Against Blindness (INBRACE) , Assis/Presidente Prudente, São Paulo , Brazil
| | - Eduardo B Rodrigues
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Michel Eid Farah
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Mauricio Maia
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil.,c Brazilian Institute of Fighting Against Blindness (INBRACE) , Assis/Presidente Prudente, São Paulo , Brazil
| |
Collapse
|
7
|
Bersanetti PA, Bueno TLN, Morandim-Giannetti ADA, Nogueira RF, Matos JR, Schor P. Characterization of Rabbit Corneas Subjected to Stromal Stiffening by the Açaí Extract (Euterpe oleracea). Curr Eye Res 2016; 42:528-533. [DOI: 10.1080/02713683.2016.1214970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Patrícia A. Bersanetti
- Departamento de Informática em Saúde, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tatiane L. N. Bueno
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Regina F. Nogueira
- Departamento de Informática em Saúde, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jivaldo R. Matos
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Brazil
| | - Paulo Schor
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
8
|
Campagnoli TR, Smiddy WE. Idiopathic epiretinal membrane management and prognosis: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1094378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
9
|
Abstracts of the European Vitreoretinal Update 2013, the 13th Euretina Congress. September 2013. Hamburg, Germany. Ophthalmologica 2013; 230 Suppl 1:1-30. [PMID: 24081148 DOI: 10.1159/000354999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
10
|
Peris CS, Badaro E, Ferreira MA, Lima-Filho AAS, Ferreira EL, Maia A, Rodrigues EB, Farah ME, Maia M. Color Variation Assay of the Anthocyanins from Açai Fruit (Euterpe oleracea): A Potential New Dye for Vitreoretinal Surgery. J Ocul Pharmacol Ther 2013; 29:746-53. [DOI: 10.1089/jop.2013.0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cristiane Siqueira Peris
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Emmerson Badaro
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Magno Antonio Ferreira
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Acácio Alves Souza Lima-Filho
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
- Ophthalmos Industry, São Paulo, Brazil
| | | | - Andre Maia
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Eduardo Buchele Rodrigues
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Michel Eid Farah
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
| | - Maurício Maia
- Department of Ophthalmology, Vision Institute (IPEPO), Federal University of São Paulo, São Paulo, Brazil
- Brazilian Institute of Fighting Against Blindness, São Paulo, Brazil
| |
Collapse
|