Intravitreal Fluocinolone Acetonide Implant in Irvine-Gass Syndrome


Intravitreal Fluocinolone Acetonide Implant in Irvine-Gass Syndrome by Ana Carolina Abreu, Bernardete Pessoa, Vania Lages, Joao Coelho, Irene Barbosa, Angelina Meireles, Portugal



To evaluate the effectiveness of a single intravitreal injection of fluocinolone acetonide implant (Iluvien®) in patients with cystoid macular edema (CME) due to Irvine-Gass syndrome.


Clinical data review of eyes with refractory CME due to Irvine-Gass syndrome, who underwent a single intravitreal injection of fluocinolone acetonide implant, Iluvien®, in Ophthalmology Department of Centro Hospitalar Universitário do Porto. Best-corrected visual acuity (BCVA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central macular thickness (CMT) before and after treatment, previous intravitreal short-acting steroids and intraocular pressure status at baseline and during the follow-up were evaluated.


Four eyes of 2 patients were included in this study. The mean duration of CME before treatment with Iluvien® was 2.25±0.43 years. All eyes had received intravitreal injections of short-acting steroids (triamcinolone and/or dexamethasone). The mean number of short-acting steroids before Iluvien® implant was 4.5 (ranging from 2 to 8). Mean follow-up was 6 months (ranging from 3 to 9 months). At baseline, mean BCVA was 67 ± 6.96 ETDRS letters and at the last visit had increased 5.75 ± 8.31 ETDRS letters. Mean CMT at baseline was 500.25 ± 30.15 µm and it improved to 315.75 ± 16.28 µm after Iluvien® injection, with a mean decrease of 184.5 ± 23.47 µm. During the follow-up, 2 eyes showed an IOP value superior to 21 mmHg. These 2 eyes had previous history of ocular hypertension. All cases were managed with IOP lowering eye drops with success. During follow-up, one eye, that presented incomplete response to Iluvien®, was submitted to vitrectomy with internal limiting me mbrane peeling, with significant improvement.


In this study, both mean CMT and mean BCVA improved after treatment with a fluocinolone acetonide implant, showing that it can be used as a therapeutic alternative in refractory cases of CME due to Irvine-Gass syndrome. Larger samples with longer follow-up are necessary to assess the stability of the results over time.


Ana Carolina Abreu
Porto, Portugal
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