Retinal architecture as a determinant of brilliant blue G phototoxicity during internal limiting membrane peeling: A case series

Figure 1 Imaging features before and after surgery - case 2. This figure corresponds to patient 2, who underwent surgery for an idiopathic macular hole (MH) in the right eye with an initial visual acuity of 6/24. A: Preoperative optical coherence tomography (OCT) revealed a fully detached posterior vitreous cortex, intraretinal cystic spaces, and intact retinal pigment epithelium (RPE) at the fovea. Internal limiting membrane (ILM) staining was performed under air for 2 minutes. The total surgical time was 95 minutes; B and C: One month postoperatively, OCT showed a closed MH with photoreceptor and RPE damage in the foveal and parafoveal regions, corresponding to the ILM peel area, with visual acuity of 6/36; D-F: At 3- and 9-months post-surgery, the hole remained closed, but progressive outer retinal and RPE thinning with increased choroidal hyperreflectivity was observed. Visual acuity at the final visit remained 6/36.