Fluocinolone Acetonide 0.19 mg Implant in Patients with Cystoid Macular Edema Due To Irvine-Gass Syndrome

João Heitor Marques; Ana Carolina Abreu; Nisa Silva; Angelina Meireles; Bernardete Pessoa; João Melo Beirão

doi:10.2147/IMCRJ.S295045

Fluocinolone Acetonide 0.19 mg Implant in Patients with Cystoid Macular Edema Due To Irvine-Gass Syndrome

Int Med Case Rep J. 2021 Feb 26:14:127-132. doi: 10.2147/IMCRJ.S295045. eCollection 2021.

Authors

João Heitor Marques¹, Ana Carolina Abreu¹, Nisa Silva¹, Angelina Meireles^{1

2}, Bernardete Pessoa^{1

2}, João Melo Beirão^{1

2}

Affiliations

¹ Serviço de Oftalmologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
² Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.

Abstract

Background: Cystoid macular edema (CME) due to Irvine-Gass syndrome (IGS) is one of the common causes of painless visual impairment post-cataract extraction. The treatment of recurrent cases remains unstandardized.

Objective: To evaluate the effectiveness and safety of fluocinolone acetonide intravitreal implant (0.2 µg/day; ILUVIEN^®) in the off-label treatment of recurrent CME due to IGS.

Methods: Retrospective 36-month case series in the Ophthalmology Department of Centro Hospitalar Universitário do Porto, Portugal. Consecutive eyes of patients with recurrent cystoid macular edema due to Irvine-Gass syndrome who underwent a single intravitreal injection of fluocinolone acetonide intravitreal implant were included. Best-corrected visual acuity (logMAR), central macular thickness (µm) and safety (intraocular pressure, mmHg) at baseline and at 6, 12, 24 and 36 months post-administration of the fluocinolone acetonide intravitreal implant were recorded.

Results: Five eyes from three patients were included. The duration of cystoid macular edema was 67.8±25.9 months and all five eyes received more than 2 intravitreal injections of a corticosteroid (triamcinolone and/or dexamethasone implant) prior to fluocinolone acetonide intravitreal implantation. At baseline (median - interquartile range), best-corrected visual acuity was 0.3-0.3; central macular thickness was 492.0-38.0; and intraocular pressure was 16.0-0. By Month 36, best-corrected visual acuity was 0.4 -0.3; central macular thickness was reduced to 369.0-324.0 and intraocular pressure was 17.0-3.0. Four of five eyes had increased intraocular pressure and were managed with intraocular pressure-lowering eye drops.

Conclusion: We report improved functional and anatomical outcomes after treatment with fluocinolone acetonide intravitreal implant, indicating its use as a therapeutic alternative in recurrent cases of cystoid macular edema due to Irvine-Gass syndrome. Additionally, in eyes with suboptimal response to intravitreal therapies, fluocinolone acetonide intravitreal implant may provide longer recurrence-free periods with reduced treatment burden.

Keywords: Irvine–Gass syndrome; cataract surgery; cystoid macular edema; fluocinolone acetonide; pseudophakic cystoid macular edema.

Publication types

Case Reports

Grants and funding

The authors declare that this work did not receive any funding.