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Kadonosono, Kazuaki MD*; Arakawa, Akira MD*; Inoue, Maiko MD*; Yamane, Shin MD*; Uchio, Eiichi MD*; Yamakawa, Tadashi MD*; Taguri, Masataka PhD; Morita, Satoshi PhD; Ridgeley, Jamison R. MD; Yanagi, Yasuo MD§

doi: 10.1097/IAE.0b013e3182807629
Original Study

Purpose: To evaluate the difference in color contrast by performing a color contrast ratio (CR) analysis and resulting visibility of the internal limiting membrane (ILM) when stained with indocyanine green and brilliant blue G (BBG) during macular surgery by performing a color CR analysis.

Methods: The authors analyzed 40 consecutive cases in which vitrectomy with ILM removal was performed to treat a macular hole or an epiretinal membrane. The surgical procedure was performed in 21 patients (21 eyes) after staining with indocyanine green and in 19 patients (19 eyes) after staining with BBG. The color CRs were estimated based on digital analysis of the red, green, and blue data of the digital images captured, and the CRs obtained with the two dyes were compared.

Results: Color contrast analysis was performed in all 40 eyes, in which the ILM was removed after staining with indocyanine green or BBG, and the CRs were estimated in every eye. The CR (mean ± SD) obtained with indocyanine green and BBG was 4.3 ± 0.3 and 2.4 ± 0.1, respectively. Indocyanine green provided a significantly higher CR than BBG (P = 0.015).

Conclusion: Digital color contrast analysis can be used to evaluate the visibility of digital images, and it may be useful when choosing the dye to use for staining the ILM better.

*Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan

Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

Department of Ophthalmology, United States Naval Hospital, Yokosuka, Japan

§Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.

Reprint requests: Kazuaki Kadonosono, MD, Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan; e-mail:

The authors have no conflicts of interest to disclose.

© The Ophthalmic Communications Society, Inc.