J Korean Ophthalmol Soc.  2014 Mar;55(3):391-395. 10.3341/jkos.2014.55.3.391.

Factors Influencing the Effect of the Intravitreal Bevacizumab Injection in Patients with Central Serous Chorioretinopathy

• Kweon EY

• KMID: 2218268
• DOI: http://doi.org/10.3341/jkos.2014.55.3.391

Abstract

PURPOSE
To evaluate the factors influencing the effect of the intravitreal bevacizumab injection in patients with central serous chorioretinopathy.
METHODS
We performed a retrospective review of the medical records of 54 patients (56 eyes) who had been symptomatic for more than 3 months with central serous chorioretinopathy (CSC), who had undergone intravitreal bevacizumab injection and been on regular follow-up for at least 6 months.
RESULTS
Responders were 34 eyes (60.7%) and non-responders were 22 eyes (39.3%). The leaking points of the non-responder group were multiple and located more centrally than that of the responder group on fluorescein angiography (FA) (p = 0.01, p = 0.044). In addition, non-responder group showed cystoid macular edema on optical coherence tomography (OCT) as compared with responder group (p = 0.042).
CONCLUSIONS
CSC with multiple, centrally located leaks on FA or cystoid macular edema on OCT was ineffective or recurrent with intravitreal bevacizumab injection.

Keyword

Bevacizumab; Central serous chorioretinopathy

MeSH Terms

Central Serous Chorioretinopathy*
Fluorescein Angiography
Follow-Up Studies
Humans
Macular Edema
Medical Records
Retrospective Studies
Tomography, Optical Coherence
Bevacizumab

Reference

References

1. Gass JD. Pathogenesis of disciform detachment of the neuroepithelium. ∏. Idiopathic central serous chorioretinopathy. Am J Ophthalmol. 1967; 63:587–615.

2. Yannuzzi LA, Gitter KA, Schatz H. The macula: a comprehensive text and atlas. 2nd ed.Baltimore: William & Wilkins;1982. p. 145–65.

3. Gilbert CM, Owens SL, Smith PD, Fine SL. Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol. 1984; 68:815–20.

4. Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy. Am J Ophthalmol. 2002; 133:787–93.

5. Iida T, Yannuzzi LA, Spaide RF, et al. Cystoid macular degeneration in chronic central serous chorioretinopathy. Retina. 2003; 23:1–7. quiz 137-8.

6. Burumcek E, Mudun A, Karacorlu S, Arslan MO. Laser photocoagulation for persistent central serous retinopathy: results of long-term follow-up. Ophthalmology. 1997; 104:616–22.

7. Battaglia Parodi M, Da Pozzo S, Ravalico G. Photodynamic therapy in chronic central serous chorioretinopathy. Retina. 2003; 23:235–7.

8. Cardillo Piccolino F, Eandi CM, Ventre L, et al. Photodynamic therapy for chronic central serous chorioretinopathy. Retina. 2003; 23:752–63.

9. Chan WM1, Lam DS, Lai TY, et al. Choroidal vascular remodel-ling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol. 2003; 87:1453–8.

10. Yannuzzi LA, Slakter JS, Gross NE, et al. Indocyanine green an-giography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina. 2003; 23:288–98.

11. Canakis C, Livir-Rallatos C, Panayiotis Z, et al. Ocular photodynamic therapy for serous macular detachment in the diffuse retinal pigment epitheliopathy variant of idiopathic central serous chorioretinopathy. Am J Ophthalmol. 2003; 136:750–2.

12. Taban M, Boyer DS, Thomas EL, Taban M. Chronic central serous chorioretinopathy: photodynamic therapy. Am J Ophthalmol. 2004; 137:1073–80.

13. Chung SE, Kang JH, Kang SW. Chronic central serous chorioretinopathy: photodynamic therapy. J Korean Ophthalmol Soc. 2007; 48:279–84.

14. Chang MH, Kim SW, Oh JR, Huh K. Photodynamic therapy with verteporfin using half fluence for chronic central serous chorioretinopathy. J Korean Ophthalmol Soc. 2009; 50:1326–33.

15. Kim M, Chung H. The result of photodynamic therapy in chronic central serous chorioretinopathy. J Korean Ophthalmol Soc. 2009; 50:1035–43.

16. Torres-Soriano ME, García-Aguirre G, Kon-Jara V, et al. A pilot study of intravitreal bevacizumab for the treatment of central serous chorioretinopathy (case reports). Graefes Arch Clin Exp Ophthalmol. 2008; 246:1235–9.

17. Huang WC, Chen WL, Tsai YY, et al. Intravitreal bevacizumab for treatment of chronic central serous chorioretinopathy. Eye (Lond). 2009; 23:488–9.

18. Seong HK, Bae JH, Kim ES, et al. Intravitreal bevacizumab to treat acute central serous chorioretinopathy: short-term effect. Ophthalmologica. 2009; 223:343–7.

19. Kim HS, Lee JH. The short-term effect of intravitreal bevacizumab for treatment of central serous chorioretinopathy. J Korean Ophthalmol Soc. 2010; 51:860–4.

20. Costa RA, Scapucin L, Moraes NS, et al. Indocyanine green-medi-ated photothrombosis as a new technique of treatment for persistent central serous chorioretinopathy. Curr Eye Res. 2002; 25:287–97.

21. Costa RA, Farah ME, Freymüller E, et al. Choriocapillaris photodynamic therapy using indocyanine green. Am J Ophthalmol. 2001; 132:557–65.

22. Guyer DR, Yannuzzi LA, Slakter JS, et al. Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol. 1994; 112:1057–62.

23. Prünte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy. Am J Ophthalmol. 1996; 121:26–34.

24. Spaide RF, Hall L, Haas A, et al. Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina. 1996; 16:203–13.

25. Lai TY1, Chan WM, Lam DS. Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy. Am J Ophthalmol. 2004; 137:826–33.

26. Tzekov R, Lin T, Zhang KM, et al. Ocular changes after photodynamic therapy. Invest Ophthalmol Vis Sci. 2006; 47:377–85.

27. Lee JY, Chae JB, Yang SJ, et al. Intravitreal bevacizumab versus the conventional protocol of photodynamic therapy for treatment of chronic central serous chorioretinopathy. Acta Ophthalmol. 2011; 89:e293–4.

28. Semeraro F, Romano MR, Danzi P, et al. Intravitreal bevacizumab versus low-fluence photodynamic therapy for treatment of chronic central serous chorioretinopathy. Jpn J Ophthalmol. 2012; 56:608–12.

29. Lim JW, Kim MU, Shin MC. Aqueous humor and plasma levels of vascular endothelial growth factor and interleukin-8 in patients with central serous chorioretinopathy. Retina. 2010; 30:1465–71.