Moschos Marilita M, Gatzioufas Zisis, Rotsos Tryfon, Symeonidis Chrysanthos, Song Xuefei, Seitz Berthold
1st Department of Ophthalmology, University of Athens, Athens, Greece.
Clin Ophthalmol. 2013;7:1437-9. doi: 10.2147/OPTH.S44200. Epub 2013 Jul 15.
Macular edema (ME) is caused by abnormal retinal capillary permeability and has also been described as a postoperative complication of cataract surgery (Irvine-Gass syndrome).
To present a patient with Irvine-Gass syndrome in the right eye complicated with a macular hole (MH) in the same eye and possible associations between these two entities.
A 72-year-old male with a history of uneventful bilateral cataract surgery was followed-up with biomicroscopy and optical coherence tomography (OCT). Four weeks after cataract surgery oculus dexter (OD), there was progressive visual deterioration (best corrected visual acuity [BCVA]: 0.5). OCT disclosed cystoid ME. A parabulbar triamcinolone injection, dexamethasone 0.1% and ketorolac 0.4% eye drops, both 4 times per day OD were administered. Six weeks later (BCVA OD: 0.2), OCT revealed cystoid ME and full-thickness MH.
ME secondary to diabetes or central retinal vein occlusion may lead to MH by inducing focal vitreomacular traction and by triggering inflammatory mechanisms which facilitate a marked thinning of the fovea. MH may occur even in cases of pseudophakic ME, representing a rare complication of Irvine-Gass syndrome.
黄斑水肿（ME）由视网膜毛细血管通透性异常引起，也被描述为白内障手术的术后并发症（ Irvine-Gass综合征）。
介绍一名右眼患有Irvine-Gass综合征并合并同眼黄斑裂孔（MH）的患者，以及这两种情况之间可能的关联。
一名72岁男性，有双侧白内障手术顺利的病史，接受了生物显微镜检查和光学相干断层扫描（OCT）随访。右眼白内障手术后四周，视力逐渐下降（最佳矫正视力[BCVA]：0.5）。OCT显示囊样黄斑水肿。给予球周注射曲安奈德，0.1%地塞米松滴眼液和0.4%酮咯酸滴眼液，右眼均每天4次。六周后（右眼BCVA：0.2），OCT显示囊样黄斑水肿和全层黄斑裂孔。
糖尿病或视网膜中央静脉阻塞继发的黄斑水肿可能通过诱导局部玻璃体黄斑牵引和触发炎症机制导致黄斑裂孔，这些炎症机制会促使中央凹明显变薄。即使在人工晶状体性黄斑水肿的病例中也可能发生黄斑裂孔，这是Irvine-Gass综合征的一种罕见并发症。
