Pseudophakic (Irvine-Gass) Macular Edema Workup

Updated: Sep 25, 2018
  • Author: David G Telander, MD, PhD; Chief Editor: Michael Taravella, MD  more...
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Workup

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. [14]

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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