Intraretinal brilliant blue infiltration during membrane limiting intern peeling: a case report

Purpose Surgical treatment of epiretinal membrane (ERM) have been facilitated by use of dyes such as brilliant blue G (BBG) whose harmlessness by intravitrael injection have been fully reported. Methods We describe the case of a seventy-two year old female patient addressed for surgical treatment of left idiopathic ERM that caused metamorphopsia and a decrease of visual acuity. Pars plana vitrectomy and ERM peeling staining with BBG was performed. Results During the procedure, an unusual complication occurs: intraretinal BBG infiltration. The area was limited (under a disc diameter) located in macular area, in temporal and superior to the fovea; the infiltration reached all retinal layers according to our OCT images. A defect in retina nerve fiber layer seems to be the origin of that staining. No damage in the field or in fluorescein and indocyanine angiography were observed. A progressive resorption of the staining appeared with atrophy of the inners retinal layers as aftereffect. Visual acuity reached 9/10 Pa2 a month and a half after the surgery. Conclusion In spite of the benefits of vital dyes in vitreoretinal surgery which are widely used, this case remains us the damage that can occur.