Intravitreal Anti-VEGF Shows Anatomic and Visual Gains in Irvine-Gass Syndrome Meta-Analysis

This systematic review and meta-analysis evaluated the efficacy of intravitreal anti-VEGF agents for Irvine-Gass syndrome (IGS), pooling data from 343 eyes of 334 patients. The analysis included seven retrospective studies and one randomized, sham-controlled, multicenter study, with a mean follow-up of 6.0 months. The comparator was sham injection in the single randomized trial; other studies lacked a formal control group.

At 6 months, treatment was associated with a mean improvement in best-corrected visual acuity (BCVA) of 0.65 logMAR (95% CI: -0.83; -0.47) and a mean decrease in central macular thickness (CMT) of 290.41 µm (95% CI: -351.33; -229.54). In the three studies reporting it, the percentage of eyes achieving resolution of cystoid macular edema (CME) ranged from 66.4% to 100%. Safety and tolerability data were not reported.

Key limitations significantly constrain the findings. The primary outcome of CME resolution was reported too heterogeneously to allow for meta-analysis. Superiority over placebo remains uncertain, as most evidence comes from retrospective studies. The authors note a need for randomized, placebo-controlled trials.

For practice, this analysis suggests potential anatomic and functional benefits of intravitreal anti-VEGF in treating IGS, but the evidence is not definitive. Clinicians should interpret these associations cautiously due to the study designs and lack of comparative efficacy data against other treatments or placebo.