Brilliant Blue G Ophthalmic Solution

What is Brilliant Blue G Ophthalmic Solution?[edit | edit source]

Brilliant blue G is a disclosing agent used in ophthalmological surgery to stain the internal limiting membrane (ILM). TissueBlue (Brilliant Blue G Ophthalmic Solution) 0.025% is a sterile solution of BBG (a dye). Each mL of TissueBlue 0.025% contains BBG 0.25 mg, Polyethylene Glycol 40mg and Buffered Sodium Chloride solution (8.20 mg of sodium chloride, 3.10 mg sodium phosphate dibasic dodecahydrate, 0.30 mg sodium phosphate monobasic dihydrate, water for injection). The pH range of TissueBlue 0.025% Solution is between 7.3 and 7.6.

What are the uses of this medicine?[edit | edit source]

Brilliant Blue G is used in an ophthalmic solution for staining the internal limiting membrane (ILM) of the eye during ophthalmic procedures. This membrane is thin and translucent, making it difficult to identify during eye surgeries that require high levels of visual accuracy. Brilliant blue G, like its name, imparts a vibrant blue color, facilitating identification of the ILM.

How does this medicine work?[edit | edit source]

The internal limiting membrane (ILM) is a thin and translucent structure that demarcates the transition from the retina from the vitreous body of the eye. It acts as a scaffold on which excessive tissue can grow, which results in visual distortion when it is projected onto the neighbouring retina. This causes visual loss and/or distortion.^[1]

An epiretinal membrane (also known as ERM) is a fibrous type of tissue that can be found on the inner surface of the retina and occurs idiopathically, and in some cases, retinal detachment and inflammation. It is often found on the surface of the internal limiting membrane (ILM), causing visual loss and distortion^[2]. The above condition as well as the associated macular pucker ^[3] or traction maculopathy ^[4] can affect the ILM, contributing to visual complications. The removal of the ILM with or without vitrectomy is often a simple solution to these conditions.

Brilliant Blue G specifically stains the internal limiting membrane (ILM) in the eye without staining the epiretinal membrane or the retina, allowing for easier surgical removal. The mechanism of its specific staining that is limited to the ILM is currently not fully understood.

Who Should Not Use this medicine?[edit | edit source]

None.

Is this medicine FDA approved?[edit | edit source]

It was approved by the FDA for ophthalmic use on December 20, 2019.

How should this medicine be used?[edit | edit source]

TissueBlue 0.025% is carefully injected into the Balanced Salt Solution (BSS)-filled vitreous cavity using a blunt cannula attached to the pre-filled syringe, without allowing the cannula to contact the retina or allowing TissueBlue to get under the retina. Sufficient staining is expected within a few seconds. Following staining, all excess dye should be removed from the vitreous cavity.

What are the dosage forms and brand names of this medicine?[edit | edit source]

Dosage form: Brilliant Blue G Ophthalmic Solution 0.025% is a clear, bright blue, single-dose ophthalmic solution supplied in 2.25mL syringes pre-filled to a volume of 0.5mL. Brand name: TissueBlue.

What side effects can this medication cause?[edit | edit source]

Adverse reactions include retinal (retinal break, tear, hemorrhage, and detachment) and cataracts.

What to do in case of emergency/overdose?[edit | edit source]

No overdose information is available.

Can this medicine be used in pregnancy?[edit | edit source]

There are no available data on the use of TissueBlue 0.025% in pregnant women to inform a drug associated risk. Systemic absorption of TissueBlue 0.025% in humans is expected to be negligible following intravitreal injection and subsequent removal of the drug at the completion of surgical procedures. Due to the negligible systemic exposure, it is not expected that maternal use of TissueBlue 0.025% will result in fetal exposure to the drug.

Can this medicine be used in children?[edit | edit source]

The safety and effectiveness of TissueBlue 0.025% in pediatric patients has not been established.

What should I know about storage and disposal of this medication?[edit | edit source]

TissueBlue 0.025% should be stored at 15°C to 25°C (59°F to 77°F). Protect from light, frost and moisture.

Research and Studies[edit | edit source]

Research on the use of Brilliant Blue G in ophthalmology continues to explore its effectiveness in surgical visualization and diagnostics, as well as its safety profile.

References[edit | edit source]

↑ Guber J, Pereni I, Scholl HPN, Guber I, Haynes RJ: Outcomes after Epiretinal Membrane Surgery with or Without Internal Limiting Membrane Peeling. Ophthalmol Ther. 2019 Jun;8(2):297-303. doi: 10.1007/s40123-019-0185-7. Epub 2019 Apr 19.
↑ Guber J, Pereni I, Scholl HPN, Guber I, Haynes RJ: Outcomes after Epiretinal Membrane Surgery with or Without Internal Limiting Membrane Peeling. Ophthalmol Ther. 2019 Jun;8(2):297-303. doi: 10.1007/s40123-019-0185-7. Epub 2019 Apr 19.
↑ Sheard RM, Sethi C, Gregor Z: Acute macular pucker. Ophthalmology. 2003 Jun;110(6):1178-84. doi: 10.1016/S0161-6420(03)00266-5.
↑ Konidaris V, Androudi S, Brazitikos P: Myopic traction maculopathy: study with spectral domain optical coherence tomography and review of the literature. Hippokratia. 2009 Apr;13(2):110-3.

Brilliant Blue G Ophthalmic Solution

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