Irvine–Gass syndrome

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Obesity, Sleep & Internal medicine
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Irvine–Gass syndrome
Synonyms	Pseudophakic cystoid macular edema
Pronounce	N/A
Specialty	N/A
Symptoms	Blurred vision, decreased visual acuity
Complications	Macular edema, vision loss
Onset	Typically occurs weeks to months after cataract surgery
Duration	Can be transient or chronic
Types	N/A
Causes	Inflammatory response following cataract surgery
Risks	Previous eye surgery, diabetes mellitus, uveitis
Diagnosis	Optical coherence tomography, fluorescein angiography
Differential diagnosis	Diabetic macular edema, retinal vein occlusion
Prevention	N/A
Treatment	Nonsteroidal anti-inflammatory drugs, corticosteroids, anti-VEGF therapy
Medication	N/A
Prognosis	Generally good with treatment, but may lead to chronic edema if untreated
Frequency	Occurs in 1-2% of cataract surgeries
Deaths	N/A

Irvine–Gass syndrome, also known as pseudophakic cystoid macular edema (PCME), is a condition characterized by the accumulation of fluid in the macula, leading to swelling and impaired vision. This syndrome typically occurs after cataract surgery and is one of the most common causes of decreased vision following the procedure.

Pathophysiology

The exact mechanism of Irvine–Gass syndrome is not fully understood, but it is believed to involve inflammation and the breakdown of the blood-retinal barrier. This leads to the leakage of fluid into the macula, resulting in cystoid macular edema. Inflammatory mediators such as prostaglandins and cytokines are thought to play a significant role in this process.

Symptoms

Patients with Irvine–Gass syndrome may experience:

• Blurred or decreased central vision
• Distorted vision (metamorphopsia)
• Difficulty reading or recognizing faces

Diagnosis

Diagnosis of Irvine–Gass syndrome is typically made through clinical examination and imaging studies. Key diagnostic tools include:

• Optical coherence tomography (OCT)
• Fluorescein angiography

Treatment

Treatment options for Irvine–Gass syndrome may include:

• Topical nonsteroidal anti-inflammatory drugs (NSAIDs)
• Topical corticosteroids
• Intravitreal injections of corticosteroids or anti-VEGF agents

Prognosis

The prognosis for patients with Irvine–Gass syndrome is generally good, especially with early diagnosis and appropriate treatment. Most patients experience significant improvement in vision with treatment, although some may have persistent visual impairment.

Prevention

Preventive measures may include the use of prophylactic NSAIDs or corticosteroids in patients undergoing cataract surgery, particularly those at higher risk for developing Irvine–Gass syndrome.

See also

• Cataract surgery
• Macular edema
• Optical coherence tomography
• Fluorescein angiography
• Nonsteroidal anti-inflammatory drug
• Corticosteroid

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