Six weeks after uncomplicated phacoemulsification, a 58-year-old patient reports blurred vision with best corrected acuity of 6/18. The anterior segment looks quiet and the fundus shows a blunted foveal reflex. Which investigation will most reliably confirm the suspected diagnosis?

• A Ultrasound B-scan of the macula
• B Electroretinogram showing reduced b-wave amplitude
• C Visual field testing with a central 10-degree programme
• D Fundus fluorescein angiography showing a petaloid pattern of perifoveal leakage ✓

Explanation

Pseudophakic cystoid macular oedema, or Irvine-Gass syndrome, peaks around 4 to 8 weeks after cataract surgery. Fundus fluorescein angiography demonstrates the characteristic petaloid pattern of perifoveal capillary leakage with late pooling in cystoid spaces, confirming the diagnosis. D-scan lacks the resolution for macular oedema, fields do not localize it, and the ERG is normal because photoreceptor function is preserved.

Reference: Parsons, Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.