Intravitreal Bevacizumab for Treatment of Chronic Central Serous Chorioretinopathy

Schaal, Karen B.; Hoeh, Alexandra E.; Scheuerle, Alexander F.; Schuett, Florian; Dithmar, Stefan

doi:10.1177/112067210901900415

Cited by 92 publications

(70 citation statements)

References 19 publications

(11 reference statements)

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“…Most case series reported no specific complications, although there is always some risk of postinjection endophthalmitis. 49 Most studies reported that IVB might be effective in terms of improving visual acuity and reducing CMT without significant complications and can be considered an optional intervention, 1,2,23,24,28,32,33 but these conclusions should be interpreted cautiously owing to the self-limiting nature of acute and even in chronic CSC. Moreover, it should be noted that the aqueous humor and plasma levels of VEGF were not significantly increased in patients with CSC compared with the healthy control group.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 98%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Younghae

et al. 2013

Eye

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Purpose To review and evaluate the effects of intravitreal bevacizumab injection (IVB) in centralserous chorioretinopathy (CSC) by meta-analysis. Patients and methods Clinical controlled studies that evaluated the effect of IVB in CSC were identified through systematic searches of Embase, PubMed, and the Cochrane Central Register of Controlled Trials. Data on the bestcorrected visual acuity (BCVA) in logMAR and central macular thickness (CMT) in mm at baseline and 6 months after IVB were extracted and compared with those treated by simple observation.Results Four clinical controlled studies were included in the meta-analysis. The IVB injection group achieved better BCVA at a follow-up of 6 months. However, the analysis showed that there were no significant differences of BCVA at 6 months after injection between IVB group and the observation group ( À 0.02 logMAR, 95% CI À 0.14 to 0.11, P ¼ 0.80). The analysis of the reduction in CMT revealed that the difference between groups was not statistically significant ( À 8.37 lm, 95% CI À 97.26 to 80.52, P ¼ 0.85). No report assessed severe complications or side effects of IVB in patients with CSC. Conclusions Meta-analysis failed to verify the positive effect of IVB in CSC based on the epidemiological literature published to date.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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

Younghae

et al. 2013

Eye

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“…Moreover, neurosensory retinal detachment can even be treated with anti-VEGF. 5 This might suggest that not the anti-VEGF-receptor effect of sunitinib was responsible for the neurosensory retinal detachment but other properties of its spectrum of action. …”

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confidence: 99%

Spectral domain optical coherence tomography findings of an iatrogenic retinal diamond deposit

Bae

Choi

Chae

2011

Eye

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Sunitinib was given in an intermittent schedule 4/2 (6-week cycle, 4 weeks on treatment, 2 weeks off treatment). The dose was reduced to 37.5 mg per day at the next treatment cycle. The patient developed the same clinical picture after re-initiating treatment. During the 2 weeks off period, a spontaneous regression of the serous detachment occurred again. Even after the reduction of sunitinib to 25 mg per day, the same 'yoyo-effect' was observed.The patient was receiving anti-hypertensive treatment at that time that included a selective beta-blocker (bisoprolol), an angiotensin-converting enzyme inhibitor (ramipril) and an angiotensin II receptor antagonist (candesartan). None of them was discontinued at any time the patient received sunitinib. The patient did not take any corticosteroids. Blood pressure was well controlled (130/80 mm Hg).Blood count, electrolytes, liver, and kidney function parameters were within normal range.The underlying mechanisms of subretinal exudation are thought to include changes of the choroidal vascular permeability and choroidal vascular perfusion. 3,4 Any medication, which can cause such changes, may be liable to induce serous retinal detachments. This is, to the best of our knowledge, the first report of a reversible neurosensory retinal detachment and retinal oedema due to sunitinib. Neovascular age-related macular degeneration and macular oedema due to vascular occlusion are the main indication for treatment with anti-VEGF in ophthalmology. Serous retinal detachment has not been reported as a side effect when using these substances. Moreover, neurosensory retinal detachment can even be treated with anti-VEGF. 5 This might suggest that not the anti-VEGF-receptor effect of sunitinib was responsible for the neurosensory retinal detachment but other properties of its spectrum of action.

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Central serous retinopathy

Tarabishy

Ahn

Mandell

et al. 2011

Arthritis Care & Research

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Intravitreal Bevacizumab for Treatment of Chronic Central Serous Chorioretinopathy

Cited by 92 publications

References 19 publications

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

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

Spectral domain optical coherence tomography findings of an iatrogenic retinal diamond deposit

Central serous retinopathy

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