Irvine-Gass Syndrome

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Definition

  • Cystoid macular oedema after intraocular surgery
  • usually occurs 1-2 months postoperatively
  • Usually resolves spontaneously within 3-6 months
  • Classification: acute < 6 months vs chronic > 6 months

Management

  • Topical therapy NSAID + steroids
    • e.g. Nevanac (Nepafenac) 3x1mg/ml or alternatively Nevanac 1x3mg/ml
    • e.g. Pred forte (Prednisolone) gtt 4x/d
    • Possible regimen:
      • 1st month: Nevanac 1x3mg/ml/d + Pred forte gtt. 4x/d
      • 2nd month: reduce Pred forte by 1 drop weekly
      • 3rd month: only Nevanac, stop when macular oedema is resolved
  • In case of persistent macular oedema
    • Other treatment options
      • Triamcinolone sub-tenon oder intravitreal
      • Diamox (Acetazolamide) p.o.
      • Intravitreal anti-VEGF
      • Ozurdex (Dexamethasone)
      • Iluvien (Fluocinolone acetonide)
  • Comment
    • There is no standardised therapy
    • Exclusion of other causes (prostaglandin drops, diabetes, venous occlusion, uveitis, AMD, poorly positioned IOL)

Sources

  • EyeWiki Irvine-Gass Syndrome
  • Kanski‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)