Results of One-Year Follow-Up Examinations after Intravitreal Bevacizumab Administration for Chronic Central Serous Chorioretinopathy

Abstract

Background: Our purpose was to report the results of 1-year follow-up examinations after intravitreal bevacizumab injection for the treatment of chronic central serous chorioretinopathy (CSC). Methods: Five eyes in 5 patients with chronic CSC were intravitreally injected with 1.25 mg/0.05 ml of bevacizumab. The need for retreatment was evaluated if spectral-domain optical coherence tomography showed the presence of subretinal fluid at the time of a 1-month follow-up examination. Best-corrected visual acuity and central foveal thickness were compared between baseline and 1 year after the first injection. Results: The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity improved from 0.23 ± 0.46 to 0.17 ± 0.47 and the mean central foveal thickness significantly decreased from 323 ± 98 µm to 171 ± 63 µm (p < 0.05). Conclusion: The intravitreal injection of bevacizumab is well tolerated in maintaining vision and reducing serous retinal detachment in patients with chronic CSC, as evaluated at a 1-year follow-up examination.

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

“…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.…”

“…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.…”

“…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.…”

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

“…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.…”