Intravitreal Bevacizumab in Treatment of Idiopathic Persistent Central Serous Chorioretinopathy: A Prospective, Controlled Clinical Study

Abstract

Our results indicate that intravitreal bevacizumab injection may be a new, promising treatment option for select patients with idiopathic persistent central serous chorioretinopathy. Continued studies with intravitreal bevacizumab in this population will help to establish its long-term efficacy.

Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy

“…Other studies have shown that intravitreal anti-VEGF agents effectively resorb subretinal fluid in up to 80% of the cases, 14 whereas our study showed resolution only in 40% of the cases after 10 months. Our study seems to be the most thorough study on the intravitreal injection of BCZ treatment in CSC to date.…”

“…BCZ has shown the ability to safely decrease intra-and subretinal fluid in the treatment of neovascular age-related macular degeneration (wet AMD), and this was also observed in the treatment of acute and chronic CSC. [14][15][16][17] However, many questions remain unanswered, because other investigators have not been able to replicate this effect using similar dosage, applications, and retreatment criteria. 18 The pharmacological pathway and pharmacodynamics of BCZ in CSC is poorly understood, and treatment rationale is based on the ability to decrease fluid from retina's ALS.…”

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

“…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.…”

“…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.…”

“…As for the inclusion criteria, the two studies by Lim et al 30 and Aydin 31 recruited patients with acute CSC of o3-month duration, whereas the other studies included those with CSC of 43 months. The included studies used the different control 32 Lim et al, 30 and Aydin 31 simply evaluated the effect of IVB after a single injection, whereas the others allowed repeated treatment with the same modality, guided by BCVA, OCT, and fluorescein angiography (FA).…”