eMedicine Specialties > Ophthalmology > Retina

Macular Edema, Irvine-Gass: Differential Diagnoses & Workup

Author: David G Telander, MD, PhD, Assistant Professor, Department of Ophthalmology and Vision Science, Division of Vitreo-Retinal Diseases and Surgery, University of California Davis School of Medicine
Coauthor(s): Christopher T Cessna, DO, Vitreo-Retinal Fellow, University of California, Davis Medical Center
Contributor Information and Disclosures

Updated: Feb 25, 2008

Differential Diagnoses

Macular Edema, Diabetic
Retinitis Pigmentosa
Retinoschisis, Juvenile

Other Problems to Be Considered

Vitreomacular traction syndrome
Epiretinal membrane
Goldmann-Favre syndrome
Macular cyst
Foveal schisis in high myopes
Nicotinic acid maculopathy

Workup

Laboratory Studies

  • Laboratory studies are guided by the suspected etiology. 
  • Fasting blood sugar, blood pressure, and lipid profile are indicated if diabetes or retinal vein occlusion is suspected.
  • Further workup for hypercoagulable state may be initiated based on the suspected etiology.

Imaging Studies

Retinal imaging can be helpful in establishing a diagnosis, an etiology, and a prognosis.  In addition, it is helpful for the measurement of therapeutic response.

  • Fluorescein angiography
    • Early and mid phase parafoveal retinal capillary leakage occurs in most cases.
    • In the late phases of the fluorescein angiogram, a petaloid pattern of leakage in the macula occurs.
    • Leakage of the optic disc late in fluorescein angiography can occur in Irvine-Gass syndrome (after cataract surgery).
  • Optical coherence tomography (OCT)
    • OCT is helpful in establishing a diagnosis and in measuring the therapeutic response.
    • Retinal thickening and cystic spaces are seen.

Histologic Findings

In the inner nuclear and outer plexiform layers of the retina, the extracellular cystic spaces are filled with serous fluid. Intracellular fluid has also been found by electron microscopy within expanded Müller cell processes. Various inflammatory cells have been found in eyes with CME with immunohistological studies.

More on Macular Edema, Irvine-Gass

Overview: Macular Edema, Irvine-Gass
Differential Diagnoses & Workup: Macular Edema, Irvine-Gass
Treatment & Medication: Macular Edema, Irvine-Gass
Follow-up: Macular Edema, Irvine-Gass
Multimedia: Macular Edema, Irvine-Gass
References
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References

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Further Reading

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Keywords

Irvine-Gass syndrome, cystoid macular edema, CME, macular fluid accumulation, cataract surgery, ocular surgery

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Contributor Information and Disclosures

Author

David G Telander, MD, PhD, Assistant Professor, Department of Ophthalmology and Vision Science, Division of Vitreo-Retinal Diseases and Surgery, University of California Davis School of Medicine
David G Telander, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: OSI/Eyetech Consulting fee Consulting

Coauthor(s)

Christopher T Cessna, DO, Vitreo-Retinal Fellow, University of California, Davis Medical Center
Christopher T Cessna, DO is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Brian A Phillpotts, MD, Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine
Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Steve Charles, MD, Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine
Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society
Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Consulting

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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