Irvine-Gass Macular Edema Responding to the Combination of Oral Mineralocorticoid-Receptor Antagonist With Dexamethasone Drops

Abstract

Long-lasting postoperative macular edema is a therapeutic challenge. The authors report an efficient combination therapy of oral mineralocorticoid receptor antagonists (eplerenone [Inspra; Pfizer, New York City, NY] or spironolactone, 25 mg/day to 50 mg/day) and topical dexamethasone (four times/day and progressive dose tapering) in three refractory cases following complex cataract or retinal detachment surgery. In Case 1, central macular thickness (CMT) decreased from 523 μm to 214 μm and visual acuity (VA) improved from 20/200 to 20/50 during a 6-month period. In Cases 2 and 3, CMT improved from 505 μm to 333 μm and from 438 μm to 316 μm during 5- and 3-month periods, respectively; however, VA remained unchanged (20/100 and 20/200) due to photoreceptor damage. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:936-942.].

Alternative treatment methods in eyes with pseudophakic cystoid macular edema

“…Mineralocorticoid receptor antagonists and spironolactone therapy, have been reported by Matet and coworkers [37], as an ef icient combination with topical dexamethasone in refractory cases following complex cataract or retinal detachment surgery. IFN alpha-2a at a dose of 3 million IU/day subcutaneously for 4 weeks has been demonstrated to be a successful treatment option for resistant chronic PCME in without any systemic or local side effects [38].…”

Alternative treatment methods in eyes with pseudophakic cystoid macular edema

“…Mineralocorticoid receptor antagonists and spironolactone therapy, have been reported by Matet and coworkers [37], as an ef icient combination with topical dexamethasone in refractory cases following complex cataract or retinal detachment surgery. IFN alpha-2a at a dose of 3 million IU/day subcutaneously for 4 weeks has been demonstrated to be a successful treatment option for resistant chronic PCME in without any systemic or local side effects [38].…”

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

“……”

Alternative treatment methods in eyes with pseudophakic cystoid macular edema

“…Mineralocorticoid receptor antagonists and spironolactone therapy, have been reported by Matet and coworkers [37], as an ef icient combination with topical dexamethasone in refractory cases following complex cataract or retinal detachment surgery. IFN alpha-2a at a dose of 3 million IU/day subcutaneously for 4 weeks has been demonstrated to be a successful treatment option for resistant chronic PCME in without any systemic or local side effects [38].…”

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

“……”

Alternative treatment methods in eyes with pseudophakic cystoid macular edema

“…Mineralocorticoid receptor antagonists and spironolactone therapy, have been reported by Matet and coworkers [37], as an ef icient combination with topical dexamethasone in refractory cases following complex cataract or retinal detachment surgery. IFN alpha-2a at a dose of 3 million IU/day subcutaneously for 4 weeks has been demonstrated to be a successful treatment option for resistant chronic PCME in without any systemic or local side effects [38].…”

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

“……”