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Published on: July 10, 2015
Methylene blue associated retinal toxicity
Sidra Zafar1, Martin Calotti2, Timothy T Xu2
1Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, 840 Walnut Street, Suite 1020, Philadelphia, PA, 19107, USA. sidrazafariqbal@gmail.com.
Background:
To describe a case of inadvertent methylene blue use during pars plana vitrectomy (PPV) for an epiretinal membrane (ERM).
Case:
A 69-year-old man presented with 1 day of severe vision loss in his left eye. Two days prior to presentation, he had undergone PPV that was complicated by accidental methylene blue use. Visual acuity (VA) at presentation to our institution was CF from his baseline VA of 20/60. Optical coherence tomography (OCT) demonstrated diffuse hyperreflectivity and thickening of the inner retinal layers. The patient was started on oral prednisone with no improvement. On postoperative month 1, VA was HM. OCT showed disruption of the inner retinal architecture, inner retinal layer thinning and focal disruption of the outer retina layers superiorly.
Conclusion:
Methylene blue may be associated with severe retinal toxicity. Given its similarity to other vital dyes in ophthalmology, care must be taken to avoid its inadvertent administration.
Insights
Inadvertent use of methylene blue during eye surgery can cause severe retinal toxicity, leading to significant vision loss. Ophthalmologists must exercise caution to prevent accidental administration of this vital dye.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Epiretinal membrane (ERM) surgery involves pars plana vitrectomy (PPV).
- Accidental administration of vital dyes can occur during ophthalmic procedures.
