IRVINE GASS SYNDROME: A DECADE AFTER CATARACT SURGERY: ABOUT 2 CASES

The first patient was 60 years old, with no general history, and had undergone uneventful phacoemulsification surgery on his right eye 12 years ago.He presented with right-sided visual blur that had been progressing for a month. n ophthalmological examination, the best-corrected visual acuity (BCVA) on the right eye was limited to 1/10,the anterior segment and vitreous were calm,and a posterior chamber implant was in place.The afferent photomotor reflex was normal and the ocular tone was 14, with macular oedema (MO) and papillary hyperaemia on the fundus .Examination of the adelphic eye was without abnormalities.Retinal angiography of the right eye showed dilatation of the perifoveal capillary network with macular oedema and papilledema. Optical coherence tomography (OCT) confirmed the CMT and showed the presence of a retinal serous detachment (RSD). OCT-Angiography (OCT-A) showed cystoid logetes with decreased vascular density predominantly in the deep plexus.The diagnosis of Irvine Gass syndrome was made. The patient was started on acetazolamide per os, topical NSAIDs and AIS, followed by a latero-bulbar injection of 40 mg triamcinolone acetonide. Progress was marked by the disappearance of the OM and DSR and an improvement in visual acuity to 4/10.The second case was a 70 year old patient with no general history, monophthalmic OD and pseudophakic OD.The second case involved a 70-year-old patient with no general history of monophthalmia of the right eye and pseudophakia of this eye for 11 years. The left eye had been lost following ocular trauma. She consulted for a right visual blur that had been evolving for 3 months.Ophthalmological examination revealed an BCVA limited to 2 metres on the right, a calm anterior segment, a calm vitreous, and papillary hyperhaemia on the right. Retinal angiography showed dilatation of the perifoveal capillary network and papilledema.OCT showed a CMT with a DSR. Indocyanine green angiography was normal.The diagnosis of Irvine Gass syndrome was made The patient was started on oral acetazolamide and given a 40 mg latero-bulbar injection of triamcinolone acetonide.Progress was favourable,with improvement in visual acuity and almost complete regression of the CMT and DSR on follow-up OCT.