Bilateral Choroidal Effusion Following Treatment Of Pseudophakic Cystoid Macular Edema (Pcme, Irvine-Gass Syndrome).

The aim of this report was to present a case of bilateral choroidal effusion following treatment of PCME with oral acetazolamide. 

Prof. Zagorski Eye Surgery Center in Nowy Sącz, Poland

Patient - 87 years old white man was referred to our Clinic with vision deterioration in the left eye. OCT scans revealed macular oedema and a diagnosis of pseudophakic cystoid macular edema (Irvine-Gass Syndrome) in the left eye was established.  Two months before this patient underwent cataract surgery in another medical center. Oral acetazolamide 250 mg twice a day and topical  NSAID’s were prescribed. One week later, the patient presented himself with bilateral vision loss. Fundoscopy and ultrasound exams revealed bilateral choroidal detachment. But OCT scans showed complete resolution of macular edema in his left eye. The condition of the choroid improved rapidly after discontinuation  of oral acetazolamide and introduction of 1% topical dexamethasone every hour and 1% atropine twice a day.  One week later we observed significant improvement of visual acuity and complete resolution of the choroidal effusion. 

Hipotensive treatment with acetazolamide can lead to choroidal effusion. The condition is casuistic, rare and ophthalmologists should be aware of it.

To the best of our knowledge, this is the first reported case of choroidal detachment following administration of oral acetazolamide in pseudophakic macular edema treatment.