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Pseudophakic (Irvine-Gass) Macular Edema Workup

  • Author: David G Telander, MD, PhD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Apr 07, 2016
 

Laboratory Studies

Laboratory studies are guided by the suspected etiology. Fluorescein angiography is useful to establish the diagnosis of Irvine-Gass syndrome and typically shows leakage from the optic nerve as well as petaloid leakage within the macula. Optical CT is useful for quantifying the amount of edema and to monitor response to treatment.

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.

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Imaging Studies

Fluorescein angiography (FA) remains the criterion standard in imaging to demonstrate the presence of CME. FA is able to detect the exudative fluid (dye) in the macula.

Optical coherence tomography (OCT) has rapidly become the most popular method to detect and follow CME. More specifically, high-resolution spectral-domain OCT (SD-OCT) has become increasing valuable and is used routinely to follow these patients.[9]

Note some patients have CME evidenced by OCT that is not detectable by FA, and, vice versa, some patients have CME detectable by FA that is not evident on OCT imaging.

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Contributor Information and Disclosures
Author

David G Telander, MD, PhD Ophthalmologist, Vitreo-Retinal Diseases and Surgery, Retinal Consultants Medical Group; Volunteer Clinical Faculty, Department of Ophthalmology, 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, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Christopher T Cessna, DO Vitreo-Retinal Specialist, Geisinger Health System

Christopher T Cessna, DO is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Brian A Phillpotts, MD, MD 

Brian A Phillpotts, MD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, National Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, George Alexandrakis, MD, to the development and writing of this article.

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Fundus photo of the right eye in a patient with cystoid macular edema.
Fluorescein angiography of the right eye (late phase) showing central macular leakage in cystic spaces around the fovea.
Optical coherence tomography (OCT) of the right eye showing central macular cystic spaces in cross-section.
Fundus photo of the right eye in a patient with cystoid macular edema from diabetic retinopathy.
Fluorescein angiography of the right eye (late phase) showing central macular leakage in cystic spaces around the fovea.
Optical coherence tomography (OCT) of the right eye showing central macular cystic spaces in cross-section.
 
 
 
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