scholarly journals Prognostic factor for the response to intravitreal bevacizumab treatment in central serous chorioretinopathy patients.

2019 ◽  
Author(s):  
Chunghyun Lee ◽  
Yu Jeong Kim ◽  
Soo Geun Joe ◽  
Sungjae Yang
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Statistical Significance ◽  
Subretinal Fluid ◽  
Intravitreal Bevacizumab ◽  
Poor Responders ◽  
Duration Of Symptoms ◽  
Recent Onset ◽  
Intravitreal Bevacizumab Injection ◽  
Baseline Visual Acuity

Abstract Objective To evaluate prognostic factors associated with good response to intravitreal bevacizumab (IVB) treatment in central serous chorioretinopathy (CSC) patients. Methods We retrospectively reviewed ninety-four eyes of 94 CSC patients who received intravitreal bevacizumab injection(IVB) (0.05 ml, 1.25 mg) as a first line treatment. Patients were divided into two groups as good responders and poor responders based on optical coherence tomography (OCT) findings 1 month after the first injection of intravitreal bevacizumab. Good responders were defined as complete resolution of subretinal fluid (SRF) on OCT 1 month after IVB. We compared baseline visual acuity, duration of symptoms, angiographic findings on fluorescein angiography, central retinal thickness (CRT), macular volume (MV),subfoveal choroidal thickness (SFCT) between two groups. Results 42 eyes were included as good responder and 52 eyes as poor responders. Mean age was 47.8±7.4 year old ingood responders and 50.6±7.8 year old in poor responders. Baseline visual acuity (logMAR) was better in good responders than poor responders, 0.19±0.19 and 0.29±0.19 respectively (p=0.015). SFCT was significantly thicker in good responders than poor responders 419.7±103.2㎛ and 376.0±99.0㎛ respectively (p=0.040). Prevalence of chronic cases was higher in poor responders (33/52) than good responders (15/42), (p=0.012). There was no statistical significance in age, sex, CRT, MVbetween two groups. Conclusion Intravitreal injection of bevacizumab can be potential option for the treatment of CSC patients, especially in case of recent onset, better baseline visual acuity with thicker choroid on OCT.

scholarly journals Increase in Central Retinal Edema after Subthreshold Diode Micropulse Laser Treatment of Chronic Central Serous Chorioretinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Maciej Gawęcki
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Fundus Autofluorescence ◽  
Subretinal Fluid ◽  
Intravitreal Bevacizumab ◽  
Thermal Reaction ◽  
Retinal Edema ◽  
Chronic Central Serous Chorioretinopathy ◽  
Intravitreal Bevacizumab Injection ◽  
Micropulse Laser

Purpose. Subthreshold diode micropulse laser (SDM) treatment is believed to be safe method of treating clinical entities involving retinal edema. We present a case of serous edematous reaction of the retina to SDM treatment.Methods. Case report.Results. A patient with chronic central serous chorioretinopathy (CSCR) was treated with SDM Yellow multispot laser. Procedure had been preceded by careful titration of the laser power, which after achieving of the threshold parameter was decreased by 50%. The follow-up visit two days after treatment revealed significant central retinal edema and subretinal fluid. Fundus autofluorescence image showed thermal reaction from the RPE in the form of small spots of hyperfluorescence corresponding to the laser multispot pattern used for treatment. Retinal edema resolved after topical bromfenac and single intravitreal bevacizumab injection. Slight pigmentary reaction from the RPE persisted.Conclusion. In the treatment of CSCR, there is a need to significantly reduce threshold SDM power parameters or simply use very low power without titration.

scholarly journals Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jay Chhablani ◽  
Gagan Kalra ◽  
Lubna Alkwatli ◽  
Bernd Fassbender ◽  
Francesca Amoroso ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Duration Of Symptoms ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.

Intravitreal Bevacizumab for Treatment of Chronic Central Serous Chorioretinopathy

2009 ◽  
Vol 19 (4) ◽  
pp. 613-617 ◽  
Author(s):  
Karen B. Schaal ◽  
Alexandra E. Hoeh ◽  
Alexander Scheuerle ◽  
Florian Schuett ◽  
Stefan Dithmar
Keyword(s):  
Repeated Measures ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Statistical Significance ◽  
Subretinal Fluid ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Injections ◽  
Central Retinal Thickness ◽  
Chronic Central Serous Chorioretinopathy

Purpose To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of intraretinal or subretinal fluid accumulation secondary to chronic central serous chorioretinopathy (CSC). Methods Twelve patients were treated with intravitreal injections of 2.5 mg bevacizumab at 6-to 8-week intervals until intraretinal or subretinal fluid resolved. Observation procedures were Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), ophthalmic examination, and optical coherence tomography (OCT), performed at 6- to 8-week intervals. Fluorescein angiography was performed at baseline visit and thereafter depending on clinical and OCT findings. Multivariate analysis of variance with repeated measures was used to calculate a statistical significance of change in BCVA and mean central retinal thickness, which were the main outcome measures. SAS statistical software was used for analyses. Results Patients received 2±1 intravitreal injections of bevacizumab on average during a follow-up of 24±14 weeks. Mean BCVA increased by 2±2 lines; the change in BCVA (log-MAR) was significant (p<0.02). Mean central retinal thickness decreased significantly over follow-up (p<0.05), with 6 patients (50%) showing complete resolution of subretinal fluid. Conclusions Anatomic and functional improvement following intravitreal bevacizumab injections suggest that vascular endothelial growth factor (VEGF) may be involved in fluid leakage in patients with chronic CSC. The results suggest a possible role for anti-VEGF agents in the treatment of chronic CSC. Further evaluation of intravitreal bevacizumab for chronic CSC in controlled randomized studies is warranted.

scholarly journals Efficacy of oral rifampicin in chronic central serous chorioretinopathy

2018 ◽  
Vol 10 ◽  
pp. 251584141880713 ◽  
Author(s):  
Ramesh Venkatesh ◽  
Manisha Agarwal ◽  
Meha Kantha
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Duration Of Symptoms ◽  
Diffuse Retinal Pigment Epitheliopathy

Objective: To evaluate the role of oral rifampicin in the management of chronic central serous chorioretinopathy. Methods: Retrospective analysis of patients diagnosed with chronic central serous chorioretinopathy (duration >3 months) and treated with oral rifampicin 600 mg daily for a maximum period of 3 months was carried out. Baseline visual acuity, fundus fluorescein angiography, and optical coherence tomography were recorded and the patients were followed up. Resolution of subretinal fluid and improvement in visual acuity were the main outcome measures. Recurrence of subretinal fluid was noted. Any adverse reaction to the drug was monitored. Results: Nine eyes of eight patients were included in the study. The average age of the patients was 41.90 years (range 32–52 years). Mean duration of symptoms was 16 months (range 3–60 months). Mean duration of follow-up was 10.11 months (range 3–33 months). Fluorescein angiography showed four eyes with subfoveal leaks and five eyes with diffuse retinal pigment epitheliopathy. Complete resolution of subretinal fluid was achieved in four of the nine eyes – two patients at the end of 1 month, one patient each at the end of 2 and 3 months, respectively. Visual acuity improvement was noted in four of the nine eyes. Three patients had one-line improvement and one patient had a two-line visual improvement. None of the patients had severe adverse events for which the drug had to be discontinued. None of the patients had recurrence of subretinal fluid after the discontinuation of the drug. Conclusion: Oral rifampicin could provide a useful, effective, and cost-effective alternative for treatment of patients with chronic central serous choroidopathy and evidence of healthier retinal pigment epithelium, those with focal leakage. It was not effective in eyes with diffuse retinal pigment epitheliopathy.

scholarly journals Chronic Central Serous Chorioretinopathy-Like Maculopathy as Atypical Presentation of Chorioretinal Folds

2017 ◽  
Vol 8 (3) ◽  
pp. 568-573
Author(s):  
Tina Xirou ◽  
Stamatina A. Kabanarou ◽  
Ilias Gkizis ◽  
Christina Garnavou-Xirou ◽  
Stavros Velissaris ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Female Patient ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Ophthalmological Examination ◽  
Chronic Central Serous Chorioretinopathy ◽  
Recent Onset ◽  
The Right ◽  
Chorioretinal Folds

Purpose: The purpose of this case report was to present the clinical data and management of a 69-year-old female patient with chorioretinal folds who developed chronic central serous chorioretinopathy-like maculopathy. Case Presentation: A 69-year-old female patient presented with a recent-onset slight decrease in visual acuity in her left eye. Her past ocular history was clear. Regarding her medical history, she had only hypertension, treated with per os medications. The patient underwent a complete ophthalmological examination. At presentation, the visual acuity was 6/6 in the right eye and 6/7.5 in the left eye. Intraocular pressure was 16 mm Ηg in both eyes. On fundoscopy, chorioretinal folds were noticed in the left eye. Spectral-domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography confirmed the diagnosis of chronic central serous chorioretinopathy-like maculopathy in the left eye, since other causes of chorioretinal folding were excluded. The right eye was normal. No treatment was given to the patient, and at the 6-month follow-up there was improvement in visual acuity, which was 6/6, and decreased subretinal fluid. Conclusions: Central serous chorioretinopathy-like maculopathy should be taken into account for the differential diagnosis of patients with chorioretinal folds.

scholarly journals Clinical Factors Associated with Low-Contrast Visual Acuity after Reduced-Fluence Photodynamic Therapy in Patients with Resolved Central Serous Chorioretinopathy and Good Baseline Visual Acuity

2021 ◽  
Vol 14 (4) ◽  
pp. 303
Author(s):  
Aya Chubachi ◽  
Akiko Miki ◽  
Mayuka Hayashida ◽  
Mari Sakamoto ◽  
Hisanori Imai ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Symptom Duration ◽  
Clinical Factors ◽  
Duration Of Symptoms ◽  
Low Contrast ◽  
Factors Associated ◽  
Baseline Visual Acuity ◽  
Fellow Eyes

This retrospective study was conducted to investigate the clinical factors associated with low-contrast visual acuity after reduced-fluence photodynamic therapy (RFPDT) in patients with resolved central serous chorioretinopathy (CSC) and good baseline visual acuity. A total of 45 eyes of 45 patients with resolved CSC at post-RFPDT and best-corrected visual acuity of >1.0 (logarithm of the minimal angle of resolution [logMAR], 0) at baseline were examined. Visual acuities of both eyes were measured at four contrast levels (100%, 25%, 12%, and 6%) at post-RFPDT. The low-contrast visual acuity (6%, 12%, and 25%) was significantly lower than the 100% contrast visual acuity in the affected eyes. Visual acuities of affected eyes were significantly worse than those of fellow eyes at any contrast levels. The degree of changes in 6% and 100% contrast visual acuities was significantly greater in affected eyes than that in fellow eyes (p < 0.05). The 6% contrast visual acuities in affected eyes at post-RFPDT were significantly associated with the symptom duration (p < 0.05). Patients with a long duration of symptoms might have disturbed low-contrast visual acuities at post-RFPDT even if their baseline visual acuities were good.

scholarly journals Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy

2020 ◽  
Vol 10 (1) ◽  
pp. 45
Author(s):  
Kyu Jin Han ◽  
Hyeong Ju Kim ◽  
Je Moon Woo ◽  
Jung Kee Min
Keyword(s):  
Visual Acuity ◽  
Layer Thickness ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Vessel Density ◽  
Foveal Avascular Zone ◽  
Retinal Layer ◽  
Healthy Controls ◽  
Retrospective Case ◽  
Capillary Vessel

We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). This retrospective case–control study included 34 eyes of 34 patients with spontaneously resolved acute CSC. The changes in retinal layer thickness and capillary VD were examined using SS-OCT and OCTA after complete resolution of subretinal fluid (SRF). The fellow eyes and 34 healthy eyes were used as controls. In the eyes with CSC, the outer retinal layer was significantly thinner than in the eyes of fellow and healthy controls. The foveal avascular zone area and VDs in the superficial and deep capillary plexus in the eyes with CSC were not significantly different from those in the eyes of fellow and healthy controls. The VD of the choriocapillaris in the eyes with CSC was significantly lower than that in the eyes of fellow and healthy controls. Correlation analyses revealed that the outer retinal layer thickness and initial visual acuity were positively correlated with the final visual acuity. Furthermore, the initial SRF area and height were negatively correlated with the outer retinal layer thickness after SRF resolution. Attenuation of outer retinal layer thickness and decreased VD of the choriocapillaris were observed in the eyes with spontaneously resolved acute CSC. The outer retinal layer thickness could be an important visual predictor of CSC.

scholarly journals Ranibizumab in Macular Edema Secondary to Branch Retinal Vein Occlusion – 24 Months Of Treatment

2019 ◽  
Vol 75 (4) ◽  
pp. 190-198
Author(s):  
Markéta Středová ◽  
Alexandr Stepanov ◽  
Jan Studnička ◽  
Jana Nekolová ◽  
Naďa Jirásková
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Ranibizumab ◽  
Duration Of Symptoms ◽  
Younger Patients ◽  
Vein Occlusion ◽  
The Mean ◽  
Common Clinical Practice ◽  
Baseline Visual Acuity ◽  
Ranibizumab Treatment

Purpose: To retrospectively evaluate the efficacy and safety of ranibizumab treatment for macular edema (ME) secondary to branch retina vein occlusion (BRVO) after 24 months. Materials and Methods: This study included 39 eyes of 39 patients with ME associated with BRVO treated at the Ophthalmology Department of Faculty Hospital in Hradec Kralove. The average age of included patiens was 69,3 years, the mean duration of symptoms before treament was 5,4 months, the mean baseline visual acuity (VA) was 54,6 ETDRS (Early Treatment Diabetic Retinopathy Study) letters, the mean baseline central retinal thickness (CRT) was 544,9 μm. At 64,1% patients a retinal laserphotocoagulation was performed before intravitreal ranibizumab. After one year, the study was discontinued by 17 patiens, the remaining 22 patients were observed for 24 months. Initially, there were 3 doses of intravitreal ranibizumab administered in monthly intervals, further injections were applied according to PRN (pro re nata) regiment. Patients were examined at baseline and then at 3, 6, 9, 12 and 24 months from initiation of the treatment. In this study, the effect of ranibizumab on functional and morphological parameters of the affected eye was monitored, the safety of this treatment was also evaluated. During the follow-up, a statistically significant improvement in VA was achieved in every visit in comparison to baseline parameters, the mean VA gain at the 3 month visit was 12,1 ETDRS letters (p < 0,001), at 6 months 12,5 letters (p < 0,001), at 9 months 10,5 letters (p < 0,001), at 12 months 12,5 (p < 0,001), at 24 months 8,6 letters (p < 0,05). There was a statistically significant decrease in CRT as well in the 3, 6, 9, 12 and 24 months visits, namely 249,0 μm (p < 0,001), 185,2 μm (p < 0,001), 187,0 μm (p < 0,001), 214,8 μm (p < 0,001) and 205,2 μm (p < 0,001). The average number of doses administered to a patient was 4,9 within 12 months and 7,1 within 24 months. The treatment had greater effect in younger patients with shorter duration of symptoms and baseline VA of less than 55 ETDRS letters (6/24 or worse. Nor serious, neighter long-term adverse events occured, only occasional intraocular pressure elevation after intravitreal application was found. Conclusion: Our results from common clinical practice are consistent with the results of large clinial trials, we confirmed particularly good treatment efficacy in younger patients with shorter duration of macular edema and poorer baseline visual acuity. The safety of ranibizumab treatment was confirmed.

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