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Toxic effects of indocyanine green, infracyanine green, and trypan blue on the human retinal pigmented epithelium

Kodjikian, L. ; Richter, T. ; Halberstadt, M. ; Beby, F. ; Flueckiger, F. ; Boehnke, M. ; Garweg, J.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, 2005, vol. 243, no. 9, p. 917-925

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    Titre
    • Toxic effects of indocyanine green, infracyanine green, and trypan blue on the human retinal pigmented epithelium
    Auteur
    • Kodjikian, L.. Department of Ophthalmology, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Richter, T.. Department of Ophthalmology, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Halberstadt, M.. Department of Ophthalmology, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Beby, F.. Department of Ophthalmology, Croix-Rousse Hospital, 103 Grande rue de la Croix-Rousse, 69004, Lyon, France
    • Flueckiger, F.. Department of Ophthalmology, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Boehnke, M.. Rothenbaumchaussee Clinic for Ophthalmology and Ophthalmosurgery, Hamburg, Germany
    • Garweg, J.. Department of Ophthalmology, Inselspital, University of Bern, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Graefe's Archive for Clinical and Experimental Ophthalmology, 2005, vol. 243, no. 9, p. 917-925. Springer-Verlag; http://www.springer.de
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:315931
    Summary
    Background: Indocyanine green, infracyanine green, and trypan blue are frequently used as aids to visualize structures removed during vitreoretinal surgery. But they may have toxic effects on the retina. We therefore compared the acute and chronic toxicities of these stains on cultured human retinal pigmented epithelial (RPE) cells using clinically relevant concentrations and an identical experimental setup for each agent. Methods: Monolayers of RPE cells were incubated with various concentrations of indocyanine green, infracyanine green (each at 0.005%, 0.05%, and 0.5%) or trypan blue (0.05%, 0.06%, 0.1%, 0.15%, and 0.5%) for 5min (acute exposure) or 6 days (chronic exposure). Using the propidium iodide assay, acute cytotoxicity was monitored at 15-min intervals for up to 3h. Chronic cytotoxicity was assessed by monitoring cell calcein esterase activity, cell proliferation, and cell morphology (viability) after 6 days of exposure. Results: Indocyanine and infracyanine green induced acute and chronic toxicities at a concentration above 0.05%. Trypan blue evoked no acute toxicity, but it was chronically cytotoxic at all tested concentrations. Conclusions: Despite thorough rinsing after application, significant amounts of the not sufficiently water soluble indocyanine and infracyanine green are retained after surgery by the eye. Trypan blue, being more water-soluble than ICG, is probably retained to the least degree. This circumstance is fortunate given that trypan blue exhibits a chronic cytotoxicity comparable to ICG at all clinically relevant concentrations. During vitrectomy, surgeons should aim to expose retinal tissue to only low concentrations of these stains and for as short a period as possible