Chronic macular edema medical treatment in Irvine-Gass syndrome: case report.
OBJECTIVE
The advent of intravitreal pharmacologic therapies opened a new perspective in the treatment of Irvine-Gass syndrome with potential side effects. In this case report we evaluated the efficacy of steroid sub-Tenon injection treatment in chronic macular edema.


METHODS
Five sub-Tenon injections, each of 0.8 cc of 4 mg betamethasone, were performed at 1-week intervals, followed by a second cycle of 5 sub-Tenon injections with the same cadency injections 4 months after the first cycle in a 52-year-old Caucasian woman with post-cataract surgery macular edema (Irvine-Gass syndrome).


RESULTS
At first examination, the patient showed a best spectacle-corrected visual acuity (BSCVA) of 0.52 (logMAR). Optical coherence tomography (OCT) showed a foveal thickness of 893+/-4 microm and total macular volume of 15.41 mm3. Eleven months after starting treatment, BSCVA was 0.39 (logMAR) with reduction in metamorphopsia and better color sensitivity. OCT showed a foveal thickness of 217 microm and total macular volume of 8.05 mm3. Differential map between the first and the last OCTs showed a foveal thickness reduction of 660 microm.


CONCLUSIONS
The significant improvement observed in this case of postsurgical macular edema showed how sub-Tenon steroidal injections proved to be useful as a first-step therapy.
Randazzo
Alessandro
A
Istituto Clinico Humanitas-Rozzano, Milano, Italy. a.randazzo@virgillio.it
Vinciguerra
Paolo
P
D001623:Betamethasone / Q000008:administration & dosage*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D009915:Orbit; D018918:Phacoemulsification / Q000009:adverse effects; D011183:Postoperative Complications; D013577:Syndrome; D041623:Tomography, Optical Coherence
D005938:Glucocorticoids; D001623:Betamethasone