title: Macular hole formation in a patient with Irvine-Gass syndrome: coincidence or rare complication?
abstract: BACKGROUND
  Macular edema (ME) is caused by abnormal retinal capillary permeability and has also been described as a postoperative complication of cataract surgery (Irvine-Gass syndrome).
  
  
  OBJECTIVE
  To present a patient with Irvine-Gass syndrome in the right eye complicated with a macular hole (MH) in the same eye and possible associations between these two entities.
  
  
  METHODS
  A 72-year-old male with a history of uneventful bilateral cataract surgery was followed-up with biomicroscopy and optical coherence tomography (OCT). Four weeks after cataract surgery oculus dexter (OD), there was progressive visual deterioration (best corrected visual acuity [BCVA]: 0.5). OCT disclosed cystoid ME. A parabulbar triamcinolone injection, dexamethasone 0.1% and ketorolac 0.4% eye drops, both 4 times per day OD were administered. Six weeks later (BCVA OD: 0.2), OCT revealed cystoid ME and full-thickness MH.
  
  
  CONCLUSIONS
  ME secondary to diabetes or central retinal vein occlusion may lead to MH by inducing focal vitreomacular traction and by triggering inflammatory mechanisms which facilitate a marked thinning of the fovea. MH may occur even in cases of pseudophakic ME, representing a rare complication of Irvine-Gass syndrome.
authors.affiliation: 1st Department of Ophthalmology, University of Athens, Athens, Greece.
authors.forename: Marilita M
authors.initials: MM
authors.lastname: Moschos
authors.forename: Zisis
authors.initials: Z
authors.lastname: Gatzioufas
authors.forename: Tryfon
authors.initials: T
authors.lastname: Rotsos
authors.forename: Chrysanthos
authors.initials: C
authors.lastname: Symeonidis
authors.forename: Xuefei
authors.initials: X
authors.lastname: Song
authors.forename: Berthold
authors.initials: B
authors.lastname: Seitz
keywords: Irvine-Gass syndrome; macular edema; macular hole