Alterations in “in vivo” histology of retina in bilateral chronic central serous chorioretinopathy after intravitreal bevacizumab

Abstract

Central serous chorioretinopathy (CSC) is characterized by an idiopathic serous detachment of the neurosensory retina at the macula resulting from deficient pumping and altered barrier function at the level of the retinal pigment epithelium (RPE). The disease often resolves spontaneously but sometimes recurs or becomes chronic [1, 2]. Chronic CSC occurs more frequently in elderly patients and is often bilateral [3–5]. This disease is characterized by multifocal, irregularly distributed and often widespread RPE changes associated with varying degrees of low-grade leakage. Persistent subretinal fluid in chronic CSC can produce severe and irreversible visual loss [6]. Chronic CSC may be associated with persistent subretinal exudation, extensive RPE atrophy, cystoid macular degeneration, and choroidal neovascularization. These factors lead to a less favorable visual prognosis [7–10]. Use of intravitreal bevacizumab has been reported in the management of CSC [11–13]. Vascular endothelial growth factor has been thought to be involved in fluid leakage in patients with chronic CSC [12]. We studied the effect of intravitreal bevacizumab on in vivo retinal histology by spectral domain optical coherence tomography (SD-OCT), in bilateral chronic CSC.