A pilot study of intravitreal bevacizumab for the treatment of central serous chorioretinopathy (Case reports)

Abstract

Intravitreal injection of bevacizumab was associated with visual improvement and reduced neurosensory detachment without adverse events in patients with CSC. Although these results are promising, further investigations would be helpful to understand this therapy for patients with CSC.

Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review

“…14 Some authors reported that laser photocoagulation was effective in shortening the duration of CSC and reducing the recurrence rate, whereas others reported no definite advantage in terms of the final vision or recurrence. 2 PDT is another option for treatment of CSC, as choroidal hyperpermeability has been suggested as the underlying pathology, but foveal atrophy was reported as a possible complication and PDT is expensive. 19,40 Recently, anti-VEGF antibody has been used in CSC as an off-label method.…”

“…19,40 Recently, anti-VEGF antibody has been used in CSC as an off-label method. [1][2][3][22][23][24]28,30,32,33,[41][42][43] Bevacizumab is a recombinant humanized full-length monoclonal antibody of VEGF that penetrates the retina and is transported into the photoreceptor outer segments, RPE, and choroid after intravitreal injection. 44 The half-life of bevacizumab in the vitreous is 5.6 days, and it remains in the eye for 4 to 6 weeks.…”

“…[1][2][3][4] The disorder is usually self-limited, although some patients are left with permanent visual impairment because of pigment epithelium and photoreceptor damage, especially in chronic CSC. 1,2,5,6 Hypotheses include abnormal alterations at the retinal pigment epithelium (RPE) level 2,3,7 and choroidal vascular hyperpermeability, as demonstrated on indocyanine green angiography. [7][8][9] CSC has a high spontaneous remission rate, but there is evidence of the benefit of early treatment.…”

“…2,21 There have been several off-label clinical trials of intravitreal bevacizumab injection (IVB) in CSC. 1,2,13,[22][23][24][25] Most showed positive results, with improved visual acuity and reduced subretinal fluid. However, these findings should be interpreted cautiously because of the self-limiting characteristics of CSC, which can show spontaneous improvement within months.…”

“…However, these findings should be interpreted cautiously because of the self-limiting characteristics of CSC, which can show spontaneous improvement within months. 1,2,12,[22][23][24][25] Therefore, we performed a meta-analysis of the efficacy of IVB in terms of visual acuity and macular thickness to gain a better perspective regarding the therapeutic options in CSC.…”