Akciğer Kanserli Hastada Gelişen Bilateral Irvine-Gass Sendromu

Her iki gözde az görme şikayeti olan, akciğer kanseri tanısı alan hastaya katarakt tanısı ile ayrı seanslarda katarakt cerrahisi uygulandı. Postoperatif dönemde görme artışı olmaması nedeni ile yapılan muayenede hastanın her iki gözünde kistoid makula ödemi olduğu görüldü. Tanı olarak Irvine-Gass sendromu düşünüldü. Hastaya medikal tedavi başlandı. Ancak hasta takiplerine gelmedi. 2 yıl sonra tekrar göz kliniğimize başvurduğunda her iki göz görme düzeyi 10/10 ölçüldü. Yapılan optik koherens tomografi görüntülerinde makula anatomisi her iki göz için doğaldı. Hasta bu sürede göz için önerilen medikal tedaviyi kullanmamış sadece kemoterapi görmüştü. Biz bu vakada akciğer kanseri gibi altta yatan bir sistemik hastalığı olan hastada postoperatif dönemde Irvine-Gass sendromu gelişme olasılığını tartıştık.

Anahtar Kelimeler:

Kanser, macula, ödem, katarakt

Development of Bilateral Irvine-Gass Syndrome in a Patient with Lung Cancer

Patient who was diagnosed with lung cancer with.complaint of decreased vision in both eyes with the diagnosis of cataract underwent cataract surgery in separate sessions. Because the visual acuity did not increase in the postoperative period, after ophtalmic examination cystoid macular edema was observed in both eyes. Irvine-Gass syndrome was considered as the diagnosis. Medical therapy was started. However, the patient did not come to follow up visits. After admitting to our hospital 2 years later his visual acuity in both eyes was measured 10/10. Optical coherence tomography images of macular anatomy were normal for both eyes. Patient did not have the recommended medical treatment he had only chemotherapy in this time period. In this case we discuss the possibility of development of Irvine-Gass syndrome in the postoperative period in patients with underlying systemic disease such as lung cancer as in this case.

PDF

___

1- Irvine SR. A newly defined vitreous syndrome following cataract surgery. Am J Ophthalmol 1953;36(5):599-619.
2- Gass JD, Norton EW. Follow-up study of cystoid macular edema following cataract extraction. Trans Am Acad Ophthalmol Otolaryngol 1969;73(4):665-682.
3- Benitah NR, Arroyo JG. Pseudophakic cystoid macular edema. Int Ophthalmol Clin 2010;50(1):139-153.
4- Flach AJ. The incidence, pathogenesis and treatment of cystoid macular edema following cataract surgery. Trans Am Ophthalmol Soc 1998;96:557-634.
5- Loewenstein A, Zur D. Postsurgical cystoid macular edema. Dev Ophthalmol 2010;47:148-159.
6- Peterson M, Yoshizumi MO, Hepler R, Mondino B, Kreiger A. Topical indomethacin in the treatment of chronic cystoid macular edema. Graefes Arch Clin Exp Ophthalmol. 1992;230(5):401–5.
7- Bergman M, Laatikainen L. Cystoid macular oedema after complicated cataract surgery and implantation of an anterior chamber lens. Acta Ophthalmol (Copenh) 1994;72(2):178–80.
8- Henderson BA, Kim JY, Ament CS, Ferrufino-Ponce ZK, Grabowska A, Cremers SL. Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment. J Cataract Refract Surg. 2007 Sep;33(9):1550-8.
9- Shelsta HN, Jampol LM. Pharmacologic therapy of pseudophakic cystoid macular edema: 2010 update. Retina 2011;31(1):4-12.
10 Moyer K, DeWilde A, Law C. Cystoid macular edema from cancer-associated retinopathy. Optom Vis Sci. 2014 Apr;91 (4 Suppl 1):66-70.
11- John R. Heckenlively , Henry A. Ferreyra Autoimmune retinopathy: A review and summary Seminars in Immunopathology. 2008 Apr;30 (2):127-134 Review
12- Schmier JK, Halpern MT, Covert DW, Matthews GP. Evaluation of costs for cystoid macular edema among patients after cataract surgery. Retina 2007;27(5):621-8.
13- Rossetti L, Chaudhuri J, Dickersin K. Medical prophylaxis and treatment of cystoid macular edema after cataract surgery. The results of a meta-analysis. Ophthalmology. 1998 Mar;105(3):397-405.