Short-term effect of anti-VEGF for chronic central serous chorioretinopathy according to the presence of choroidal neovascularization using optical coherence tomography angiography.

Yong-Yeon Song,Min-Woo Lee,Young-Hoon Lee,Seung-Kook Baek,Hwa-Young Yu,Alon Harris

doi:10.1371/journal.pone.0245342

Yong-Yeon Song, Min-Woo Lee + Show 4 more

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https://doi.org/10.1371/journal.pone.0245342

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Journal: PloS one	Publication Date: Jan 11, 2021
Citations: 3	License type: CC BY 4.0

Affiliation: Konyang University

Abstract

PurposeTo analyze the short-term therapeutic efficacy of intravitreal injection of bevacizumab (IVB) for chronic central serous chorioretinopathy (CSC) according to the presence of choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA).MethodsA retrospective chart review was perfomed on cases of CSC with CNV (Group 1: n = 31) and an age-matched cases of CSC without CNV (Group 2: n = 30). The response to IVB was evaluated by changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), and pachyvessel diameter. Univariate and multivariate linear regression analyses were performed to identify factors associated with the visual outcome of chronic CSC with CNV after IVB.ResultsAt baseline, the CT values differed significantly between Groups 1 and 2 (371.55 ± 67.09 vs. 417.33 ± 71.32 μm, p = 0.01). In Group 1, BCVA improved significantly (p < 0.001), and CMT (p < 0.001), CT (p = 0.001) and pachyvessel diameter (p = 0.045) decreased significantly, after IVB. In Group 2, only pachyvessel diameter (p = 0.001) was significantly smaller after IVB. Univariate analysis showed that the initial CT (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome. In multivariate analysis, the initial pachyvessel diameter exhibited significant results (B = 0.002, p = 0.001).ConclusionsIVB showed less effective short-term outcomes in chronic CSC patients without CNV than in patients with CNV. In chronic CSC with CNV, the short-term visual outcome after IVB was better in patients with a thinner choroid and smaller pachyvessels.

Highlights

Central serous chorioretinopathy (CSC) is characterized by serous retinal detachment with or without retinal pigment epithelial (RPE) detachment, which usually involves the macula.[1]
Univariate analysis showed that the initial choroidal thickness (CT) (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome
In chronic CSC with choroidal neovascularization (CNV), the short-term visual outcome after injection of bevacizumab (IVB) was better in patients with a thinner choroid and smaller pachyvessels

Summary

Introduction

Central serous chorioretinopathy (CSC) is characterized by serous retinal detachment with or without retinal pigment epithelial (RPE) detachment, which usually involves the macula.[1]. CSC usually has a good prognosis characterized by spontaneous regression of subretinal fluid (SRF) and symptoms within 4 months; only 5–10% of patients experience chronic or recurrent CSC which results in RPE atrophy and severe vision loss [3]. Chronic CSC is characterized by persistent SRF and widespread RPE alterations, including photoreceptor elongation, subretinal fibrosis and, occasionally choroidal neovascularization (CNV) [4,5]. CNV develops in 4–8% of chronic CSC patients [6,7]. Several studies reported that anti-VEGF treatment was effective for chronic CSC patients [8,9,10]. Anti-VEGF agents have an important role in treating chronic CSC with CNV [11]

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