Título

IRVINE-GASS SYNDROME OCCURRING SIMULTANEOUSLY WITH CENTRAL SEROUS CHORIORETINOPATHY

Introdução / Purpose

Cystoid Macular Edema (CME) is one of the most common complications of cataract surgery. The pathogenesis of CME secondary to cataract surgery, also known as Irvine-Gass Syndrome (IG), remains unclear, however, postoperative inflammation is cited as the major cause. Central serous chorioretinopathy (CSC) is characterized by serological detachment between the sensorineural retina and the retinal pigment epithelium (RPE). In this case report, characteristics of both pathologies can be found, with IG making the diagnosis of CSC more difficult.

Material e Método / Methods

Does not apply

Resultados / Results

Male, 47 years old, presented, 3 weeks after cataract surgery, low visual acuity (VA) in the left eye (OS). He presented a failed penetrating transplant in the right eye (OR) and, in OS, anterior repetition uveitis with secondary development of cataracts. He also had a personal history of ankylosing spondylitis.
At ophthalmological examination VA was 20/80 OS. Fundoscopy in OS presented macular thickening. The angiofluoresceinography showed macular edema with a classic petalloid pattern.
After the correct treatment, there was significant worsening of intra-retinal cysts and VA, so the option was intravitreal implant of dexamethasone. A week after implantation was evident a pigmentary epithelium detachment (PED) and the OCT-Enhanced Depth Imaging (OCT-EDI) showed an increase. Spironolactone was introduced. After 8 weeks, achieved complete resolution of retinal detachment and VA of 20/20. The patient remains without recurrence after 6 months.

Discussão e Conclusões / Discussion

The case reported has the peculiarity of presenting both signs of IG and of CSC. It is described in literature the worsening of the CSC with the use of corticosteroids, but Daruich et al found that the use of intravitreal corticosteroids to treat macular edema has not been associated with increased incidence of CSC. Therefore, we believe that Irvine-Gass improved due to the use of corticosteroids and it did not influence evolution of CSC.

Palavras Chave

IRVINE-GASS SYNDROME, CENTRAL SEROUS CHORIORETINOPATHY.