Chronic macular edema medical treatment in Irvine-Gass syndrome: Case report

PURPOSE. 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 μm and total macular volume of 15.41 mm ³. 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 μm and total macular volume of 8.05 mm³. Differential map between the first and the last OCTs showed a foveal thickness reduction of 660 μm. 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.