Abstract
Purpose: The author report the result of three consecutive monthly intravitreal ranibizumab injection for choroidal neovascularization (CNV) after bevacizumab injection for chronic central serous rethinopathy (CSR). Methods: A 48 year old man with chronic CSR was treated with intravitreal single dose 2.5 mg bevacizumab. One year after CNV was occurred, and three consecutive monthly intravitreal ranibizumab injections were performed. Results: Four weeks later the first ranibizumab dose, best corrected visual acuity was improved 20/80 to 20/20 and remained stable within one year. Conclusion: Repeat intravitreal ranibizumab injection in CNV after bevacizumab injection for chronic CSR appeared to be an effective treatment option.
Highlights
Central serous chorioretinopathy (CSR) is common diseases of the posterior segment of the eye characterized by serous detachment of the neurosensory retina in the macula secondary to an idiopathic leakage in the outer blood-retinal barier at the retinal pigment epithelium (RPE)
Different treatment options including photodynamic theraphy with vertaporfin, laser photocoagulation, vitroretinal submacular surgery and intravitreal anti vascular endothelial growth factor (VEGF) agents have been reported for the chronic and recurrent central serous rethinopathy (CSR) with or without choroidal neovascularization (CNV). [2,3,4,5] We report the results of three consecutive monthly intravitreal ranibizumab injection for CNV after bevacizumab injection for chronic CSR
Chronic CSR which known as diffuse retinal epitheliopathy characterised by persistent or recurrent serous retinal detachment with widespread pigmentary changes, decompenstation of the RPE, multifocal or diffuse RPE alteration, increased permeability of the choroidal vessels
Summary
Central serous chorioretinopathy (CSR) is common diseases of the posterior segment of the eye characterized by serous detachment of the neurosensory retina in the macula secondary to an idiopathic leakage in the outer blood-retinal barier at the retinal pigment epithelium (RPE). Visual distortions are usually mild and spontaneous recovery occurs within a few months, some patients with CSR have a poor visual acuity due to retinal pigment epithelium atrophy, persistant or recurrent pigment epithelial detachment, subretinal fluid and choroidal neovascularization (CNV) [1]. CNV secondary to CSR is an uncommon relation which has been noted to complicate laser photocoagulation treatment due to the puncture of Bruch’s membrane by laser burns and photodynamic theraphy due to the RPE alterations and induces the release of vascular endothelial growth factor (VEGF) [2]. Different treatment options including photodynamic theraphy with vertaporfin, laser photocoagulation, vitroretinal submacular surgery and intravitreal anti VEGF agents (bevacizumab or ranibizumab) have been reported for the chronic and recurrent CSR with or without CNV. Intravitreal ranibizumab injection for CNV after bevacizumab injection for chronic CSR.
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