BBG ILM monochrome mode.

This retrospective comparative study aimed to investigate the relationship between saturation and contrast when using Brilliant Blue G (BBG) staining in internal limiting membrane (ILM) peeling during vitreoretinal surgery using the NGENUITY® 3D Visual System (NGENUITY), a three-dimensional digital monitor. Participants were individuals undergoing vitreoretinal surgeries involving ILM peeling with BBG staining, performed by the same surgeon at Juntendo University Urayasu Hospital, from October 2022 to June 2023, using the NGENUITY system. After ILM peeling, the contrast ratio between the ILM-peeled area and stained area was calculated using normal color tone (Normal group) and color tone set to yellow, with saturation set to 0 (Monochrome-0 group) or 20 (Monochrome-20 group). The visibility of retinal hemorrhage was also examined. The findings were compared among the groups. The contrast ratios of surgical screens with different color settings were used as the main outcome measure. We included 27 patients (27 eyes; 16 female individuals; age: 68.9 ± 9.8 years). The contrast ratios were 1.62 ± 0.15, 2.05 ± 0.44, and 2.00 ± 0.51 in the Normal, Monochrome-0, and Monochrome-20 groups, respectively. The contrast ratios were significantly higher in the Monochrome-0 and Monochrome-20 groups than in the Normal group (both p < 0.01), whereas these ratios were similar in the Monochrome-0 and Monochrome-20 groups (p = 0.554). Although distinguishing retinal hemorrhage was difficult in the Monochrome-0 group, this distinction was possible in the Monochrome-20 group. In BBG staining of the ILM, using the monochromatic mode with the NGENUITY system improves contrast visibility; however, using slight saturation facilitates distinction of retinal hemorrhage and allows safe ILM peeling.

本回顾性对照研究旨在探究应用NGENUITY®3D视觉系统（NGENUITY® 3D Visual System，一款三维数字监视器）行玻璃体视网膜手术时，采用亮蓝G（Brilliant Blue G, BBG）染色剥离内界膜（internal limiting membrane, ILM）过程中，饱和度与对比度之间的关联。研究对象为2022年10月至2023年6月期间，在顺天堂大学浦安医院由同一位术者施行BBG染色ILM剥离术的玻璃体视网膜手术患者。ILM剥离完成后，分别通过正常色调（正常组）、色调设置为黄色且饱和度为0（单色-0组）或饱和度为20（单色-20组）三种方式，计算ILM剥离区域与染色区域间的对比度。同时评估视网膜出血的可视性，并对各组结果进行比较。本研究的主要结局指标为不同色调设置下手术画面的对比度。本研究共纳入27例患者（27只眼；其中女性16例；年龄68.9±9.8岁）。正常组、单色-0组与单色-20组的对比度分别为1.62±0.15、2.05±0.44及2.00±0.51。单色-0组与单色-20组的对比度均显著高于正常组（均p<0.01），而两组间对比度差异无统计学意义（p=0.554）。尽管单色-0组难以区分视网膜出血，但单色-20组可清晰辨别该病变。在ILM的BBG染色操作中，使用NGENUITY系统的单色模式可提升对比度可视性；但采用轻度饱和度设置则有助于区分视网膜出血，可安全完成ILM剥离术。