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SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN IRVINE–GASS SYNDROME

Minnella, Angelo Maria MD; Savastano, Maria Cristina MD; Zinzanella, Gaetano MD; Mazzone, Giacomilde MD; Federici, Matteo MD; Gari, Mariangela MD; Falsini, Benedetto MD; Balestrazzi, Emilio MD

doi: 10.1097/IAE.0b013e31821e2225
Original Study

Purpose: To report longitudinal evaluation of morphology and function, by spectral-domain optical coherence tomography and Early Treatment Diabetic Retinopathy Study visual acuity, respectively, in patients with cystoid macular edema after cataract surgery (Irvine–Gass syndrome).

Methods: Fifteen eyes (15 patients) with a diagnosis of cystoid macular edema related to Irvine–Gass syndrome underwent ocular ophthalmologic examinations including Early Treatment Diabetic Retinopathy Study visual acuity and macular morphology assessment by spectral-domain optical coherence tomography. An observational period of 3 months after surgery was considered before starting therapy with oral acetazolamide and topical indomethacin. Patients' eyes were tested at baseline and at 3, 6, and 12 months posttreatment by spectral-domain optical coherence tomography and Early Treatment Diabetic Retinopathy Study visual acuity. Repeated measures analysis of variance was used to compare mean values.

Results: Mean (±SD) central macular thickness by spectral-domain optical coherence tomography was 530 (±98.1), 385.6 (±55.1), 339 (±32.3), and 316.2 (±27.0) μm at baseline, 3, 6, and 12 months of follow-up, respectively (P < 0.001). Mean (±SD) Early Treatment Diabetic Retinopathy Study visual acuity was 0.6 (±0.2), 0.2 (±0.1), 0.16 (±0.1), and 0.09 (±0.07) logarithm of the minimum angle of resolution at baseline, 3, 6, and 12-month follow-up, respectively (P < 0.001). Macular thickness changes were positively correlated (r = 0.75; P < 0.001) with visual acuity changes. Eyes with interruption of inner segment/outer segment junction at baseline (n = 3, 20%) showed a persistent damage of the photoreceptor junction and incomplete visual acuity recovery at the end of follow-up.

Conclusion: Spectral-domain optical coherence tomography detects retinal findings, including photoreceptor inner segment/outer segment junction abnormalities that are correlated with visual acuity changes in treated patients with Irvine–Gass syndrome.

Longitudinal evaluation revealed significant morphologic macular spectral-domain optical coherence tomography alterations associated with visual acuity changes in Irvine–Gass treated patients.

From the Department of Ophthalmology, Catholic University “Sacro Cuore—Policlinico A. Gemelli,” Rome, Italy.

A. M. Minnella and M. C. Savastano contributed equally to this article.

The authors have no financial interest or conflicts of interest.

Reprint requests: Angelo Maria Minnella, MD, Department of Ophthalmology, Catholic University “Sacro Cuore—Policlinico A. Gemelli,” Largo A. Gemelli, 1, Rome 00168, Italy; e-mail: aminnella59@gmail.com

© 2012 by Ophthalmic Communications Society, Inc.