Six weeks after uncomplicated phacoemulsification, a 55-year-old patient reports blurred distance vision that improves when reading. Fundus examination shows blunted foveal reflex. Which investigation will best confirm the suspected diagnosis, and what is its classic finding?

• A Corneal topography showing irregular astigmatism centred on the incision
• B B-scan ultrasonography showing thickened choroid with serous detachment
• C Gonioscopy showing pigment and flare in the anterior chamber angle
• D Fundus fluorescein angiography showing a petaloid pattern of peri foveal leakage in late frames ✓

Explanation

Pseudophakic cystoid macular oedema (Irvine-Gass syndrome) typically peaks around 4 to 8 weeks after surgery and causes reduced acuity out of proportion to the anterior segment findings. Fluorescein angiography demonstrates early perifoveal capillary leakage accumulating in a petaloid pattern in late frames, and optical coherence tomography shows intraretinal cystoid spaces. The other tests assess structures unrelated to macular oedema.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.