Abstract

A 74-year-old lady came to our retina department for routine ophthalmic evaluation. Bilateral fundus revealed diffuse and multiple chorioretinal atrophic patches with few bony spicules in the periphery and cystoid macular edema (CME). Elevation of plasma ornithine was noted. Considering the scenario we made a clinical diagnosis of CME in case of gyrate atrophy (GA). CME was treated with dexamethasone implant in both eyes. Her best corrected visual acuity improved from to 6/18, N8 to 6/9, N6 in both eyes. She was instructed to have arginine restricted diet and review after 3 months. The treatment of macular edema in GA includes carbonic anhydrase inhibitors, topical non-steroid anti-inflammatory drugs, and intravitreal or periocular corticosteroid or vascular endothelial growth factor antagonists, either separately or in combination. To the best of our knowledge, this is the first reported case from India demonstrating the role of dexamethasone implant in CME associated with GA.