Purpose: To present the current state-of-the-art information regarding the properties, indications, surgical techniques, and toxic effects of current and past applications of vital dyes in chromovitrectomy. Design: Critical analysis and surgical perspective of the literature, recent studies and personal contributions. Methods: Review, interpretation, and comments regarding the most relevant experimental as well as clinical studies including the authors' clinical and laboratory research. Results: The evolution of vitreoretinal surgical techniques has been worldwide reported. Chromovitrectomy plays an important hole in these innovations and is very useful to improve the surgical results. There is a consensus that application of vital dyes facilitates the delicate removal of intraocular membranes during vitreoretinal surgery. Controversy still remains around various issues, mainly potential toxicity and safety. The dyes currently used for different steps in chromovitrectomy are: triamcinolone acetonide for vitreous identification; indocyanine green, infracyanine green, and brilliant blue for internal limiting membrane identification and trypan blue for epiretinal membrane identification. The indocyanine green may be toxic for the retinal pigment epithelium if subretinal migration occurs during the surgical procedure. Efforts to avoid subretinal migration of dyes are very important during macular hole surgery. The physiological osmolarity around 270-320mOsm as well as ideal concentrations of the vital dyes during vitreoretinal surgery are important subjects. Conclusions: The state-of-the-art staining-assisted procedures should be performed using concentrations and volumes as low as possible. Triamcinolone acetonide is the ideal dye for vitreous; indocyanine green, infracyanine green and brilliant blue are the ideal dyes for internal limiting membrane; trypan blue is the ideal dye for epiretinal membrane identification.

Primary central nervous system lymphoma is a rare primary brain tumor, accounting for 1% to 3% of all central nervous system malignancies, which may affect the eye in up to a quarter of the cases. Failure to diagnose and treat the ocular component increases morbidity and mortality. Ninety-eight percent of the cases of intraocular lymphomas are non-Hodgkin's B-cell. They may affect both the vitreous and the retina, while secondary invasion from a nodal lymphoma usually affects the uvea. Both forms frequently masquerade as intraocular inflammation. Systemic chemotherapy, alone or in combination with radiotherapy has been used for the treatment of these malignancies. However, when ocular involvement is present, due to the limited penetration through the blood-retina barrier of most of these drugs, adjuvant therapies should be employed. Ocular radiation have been administered in the past, however, due the high rate of recurrences, as well as the commonly seen side effects prompted additional modalities of treatment such intravitreal methotrexate and rituximab. Resumen Los linfomas primarios del sistema nervioso central (SNC) son una causa poco común de tumores cerebrales, constituyendo sólo del 1 al 3% de todas las neoplasias del SNC, pudiendo afectar al ojo en un cuarto de los casos. La falla en el diagnóstico y el tratamiento del componente ocular incrementa la morbilidad y mortalidad de estos pacientes. En el 98% de los casos de linfoma intraocular se trata de un linfoma no Hodgkin de células B. Pueden afectar tanto el vítreo como la retina, mientras que una invasión secundaria a partir de un linfoma nodal puede afectar la úvea. Ambas formas pueden enmascararse como una inflamación intraocular. Quimioterapia sistémica, solo o en combinación con radioterapia ha sido el tratamiento de elección. Sin embargo, si existe un componente ocular, debido a la limitación en la penetración de estos medicamentos a través de la barrera hemato-retiniana, terapia co-adyuvante debe ser considerada. La radiación de los tejidos oculares ha sido empleada en el pasado, no obstante, debido a la alta tasa de recurrencias y a los frecuentes efectos secundarios se han estudiado otras opciones de tratamiento como la inyección intravítrea de metrotexate y rituximab. Palabras clave: Malignidad ocular, linfoma ocular, linfoma del sistema nervioso central, sarcoma de células reticulares, linfomas de células B no Hodgkin, síndromes de enmascaramiento, metrotexate, rituximab.