Analysis of effectiveness of angiogenesis inhibitor in treatment of choroidal neovascularization in patients with chronic central serous chorioretinopathy

2021 ◽  
pp. 163-166
Author(s):  
N.S. Zhaivoronok ◽  
◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
L.P. Danilova ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Initial Level ◽  
Angiogenesis Inhibitor ◽  
Light Sensitivity ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Complete Obliteration ◽  
Object Of Study

Purpose. To evaluate efficacy of angiogenesis inhibitor ranibizumab (Lucentis, Novartis, Switzerland) in treatment of choroidal neovascularization (CNV) in patients with chronic central serous chorioretinopathy (CSCR). Material and methods. The object of study was 11 patients (8 men and 3 women, 11 eyes) aged from 41 to 50 years with CNV on the background of chronic CSCR. All monitored patients underwent 3 consecutive “loading” intravitreal Lucentis injections is either 0.5 mg in 0.05 mL once a month. Results. After 3 months, all studied patients had complete obliteration of CNV. At the same time, the central retinal thickness was 224.5±13.3 µm, which did not differ significantly from norm (p<0.05). All 11 patients had stabilization of visual functions with average index of best corrected visual acuity of 0.9±0.13, exceeding the initial level by 0.15±0.04 (p<0.05), an increase in light sensitivity of central retinal zone was noted up to 22.41±1.2 dB. Conclusion. The data obtained allow us to state that timely use of angiogenesis inhibitor Lucentis in treatment of CNV in patients with the chronic CSCR is pathogenetically justified, effective and safe. Given frequency of recurrence, further studies of anti-VEGF therapy in treatment of chronic CSCR are needed to determine the need for repeated injections of anti-VEGF drugs. Key words: central serous chorioretinopathy, choroidal neovascularization, Lucentis.

Combined approach to the treatment of choroidal neovascularization in patients with chronic central serous chorioretinopathy

2021 ◽  
pp. 226-229
Author(s):  
E.V. Erohina ◽  
◽  
Y.A. Sidorova ◽  
Keyword(s):  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Angiogenesis Inhibitor ◽  
Angiogenesis Inhibitors ◽  
Main Group ◽  
Control Group ◽  
Laser Exposure ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Neurosensory Retina

Purpose. To evaluate the effectiveness of combined treatment of chronic central serous chorioretinopathy (CCSCRP) complicated by 1st type choroidal neovascularization (CNV), using subthreshold micropulse laser exposure (SMILV) on the retina and intravitreal administration of angiogenesis inhibitors (IAOAI). Material and methods. In the period from 2017 to 2019, 37 patients (20 men and 16 women) with monolateral chronic recurrent CCSCRP complicated with CNV 1st type, were observed at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution. The aged of patients were from 35 to 57 years. In the main group were included 22 patients (22 eyes). In the main group, the anti-VEGF drug was injected once at the initial stage of treatment. During the follow-up examination before the next injection, while the detachment of the neurosensory retina persisted, the patients were immediately transferred to the combination therapy (SMILV + IAOAI). 15 patients (15 eyes) were included in the control group, whose treatment was started with 5 loading doses of the anti-angiogenic drug with an interval of 4 weeks. Results. In the main group, the number of IAOAI varied from 5 to 8 (6.1 ± 0.8). After a single injection of an angiogenesis inhibitor, a positive result was achieved in 3 cases (14%). These patients were performed two additional IAOAI with an interval of 4 weeks, then the interval was increased to 8 weeks. 19 patients (86%) had the detachment of the neurosensory retina with a height of 135-252 µm (177±28.2 µm). SMILV followed by IAOAI was performed for these patients. During the year of observation, from 8 to 10 injections of the inhibitor (8.8 ± 0.77) were performed in the control group of the study. The positive effect after injections of the anti-VEGF drug for 5 months was achieved only in 6 cases (42%). Conclusion. The proposed combination of laser exposure followed by the administration of an angiogenesis inhibitor is effective and can be used as an alternative and safe treatment for 1st type choroidal neovascularization in patients with chronic cerebrovascular accident. Key words: choroidal neovascularization, chronic central serous chorioretinopathy, intravitreal administration of angiogenesis inhibitors, subthreshold micropulse laser exposure.

scholarly journals Factors Predicting Response to Selective Retina Therapy in Patients with Chronic Central Serous Chorioretinopathy

2022 ◽  
Vol 11 (2) ◽  
pp. 323
Author(s):  
Minhee Kim ◽  
Seung Hee Jeon ◽  
Ji-young Lee ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Central Macular Thickness ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Safety And Efficacy ◽  
Selective Retina Therapy ◽  
Corrected Visual Acuity ◽  
Anatomical Outcomes ◽  
Best Corrected Visual Acuity

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.

scholarly journals Multimodal Imaging in the Management of Choroidal Neovascularization Secondary to Central Serous Chorioretinopathy

2020 ◽  
Vol 9 (6) ◽  
pp. 1934 ◽  
Author(s):  
Ahmed M. Hagag ◽  
Shruti Chandra ◽  
Hagar Khalid ◽  
Ali Lamin ◽  
Pearse A. Keane ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Predictive Biomarkers ◽  
Response To Treatment ◽  
Anti Vegf ◽  
Increased Risk ◽  
One Year

The diagnosis and treatment of choroidal neovascularization (CNV) in eyes with chronic central serous chorioretinopathy (CSCR) can be challenging. The purpose of this study was to classify eyes with suspected CNV using multimodal imaging. The effect of intravitreal anti-vascular endothelial growth factor (VEGF) was assessed and compared to controls. This retrospective study included chronic CSCR patients with suspected secondary CNV who received intravitreal bevacizumab. Eyes were divided into “definite CNV” and “no CNV” based on optical coherence tomography angiography (OCTA). Eyes that did not undergo OCTA imaging were considered as “presumed CNV”. One-year outcome in visual acuity (VA) and central foveal thickness (CFT) were investigated and compared to non-treated control patients to assess the response to anti-VEGF. Logistic regression analysis was used to explore predictive biomarkers of CNV detection and improvement after anti-VEGF. Ninety-two eyes with chronic CSCR from 88 participants were included in this study. Sixty-one eyes received bevacizumab and 31 eyes were non-treated control subjects. The presence of subretinal hyperreflective material (SHRM) and shallow irregular retinal pigment epithelium (RPE) elevation (SIRE) with sub-RPE hyperreflectivity on OCT was associated with a significantly increased risk of detecting CNV on OCTA. Intravitreal anti-VEGF caused significant functional and anatomical improvement in patients with neovascular CSCR as compared to non-treated eyes. In contrast, VA and CFT changes were not significantly different between treated and non-treated CSCR with no evidence of CNV on OCTA. No clinical or anatomical biomarkers were found to be associated with response to treatment. In conclusion, OCTA should be used to confirm the presence CNV in suspected chronic CSCR patients. Intravitreal anti-VEGF treatment resulted in a significantly better one-year outcome in patients with definitive OCTA evidence of CNV.

Anti-VEGF-Therapie bei myopischer choroidaler Neovaskularisation: Langzeitergebnisse

2015 ◽  
Vol 1 (1) ◽  
pp. 38-39
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Myopic Choroidal Neovascularization ◽  
Retrospektive Analyse ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Best Corrected Visual Acuity

Ziel: Beurteilung der mittel- und langfristigen Wirksamkeit von Anti-VEGF-Wirkstoffen in der Behandlung der choroidalen Neovaskularisation infolge einer pathologischen Myopie (myopic choroidal neovascularization; mCNV).Methoden: Retrospektive Analyse von mCNV-Patienten, die 2 Jahre oder länger mit einer intravitrealen Anti-VEGF-Therapie behandelt worden waren. Wir verglichen die Sehschärfe mit bester Korrektur (best-corrected visual acuity; BCVA) sowie die zentrale Netzhaut-Dicke (central retinal thickness; CRT) vor und nach der Behandlung. Die Anzahl der Injektionen pro Jahr wurde ebenfalls erfasst.Ergebnisse: Auswertungen der Ergebnisse erfolgten nach 2 Jahren für 67 Augen, nach 3 Jahren für 52 Augen, nach 4 Jahren für 28 Augen und nach 5 Jahren für 13 Augen. Die mittlere Veränderung der BCVA gegenüber dem Ausgangswert war nach 2 Jahren signifikant (+8,6 Buchstaben; p < 0,001); diese Verbesserung blieb über einen Zeitraum von 5 Jahren signifikant stabil bestehen. Die mittlere CRT nahm im Verlauf signifikant ab; der Tiefstwert war nach 2 Jahren erreicht (-104,0 μm; p < 0,001). Die mittlere Anzahl der Injektionen betrug im 1. Jahr 5,2 und ging in den nachfolgenden Jahren zurück (p < 0,001).Schlussfolgerung: In der hier beschriebenen Untergruppe von mCNV-Patienten war die intravitreale Anti-VEGF-Therapie über einen Zeitraum von 5 Jahren wirksam, wobei sich der BCVA-Wert fortwährend erhöhte.Übersetzung aus Ophthalmologica 2014;232:57-63 (DOI: 10.1159/000360307)

scholarly journals Characteristics and Associated Factors of Flat Irregular Pigment Epithelial Detachment With Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yongyue Su ◽  
Xiongze Zhang ◽  
Yuhong Gan ◽  
Yuying Ji ◽  
Feng Wen
Keyword(s):  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Pigment Epithelial Detachment ◽  
Chronic Central Serous Chorioretinopathy ◽  
Pigment Epithelial ◽  
Imaging Characteristics

Purpose: Flat irregular pigment epithelial detachment (FIPED) in chronic central serous chorioretinopathy (CSC) is strongly associated with type 1 choroidal neovascularization (CNV). The present study aimed to describe the multimodal imaging characteristics of FIPED in patients with chronic CSC and investigate the factors associated with vascularized FIPED.Methods: We included 55 chronic CSC eyes with vascularized FIPED (47 patients) and 55 chronic CSC eyes with avascular FIPED from age-matched patients (47 patients). None of the included eyes had a history of previous treatment with anti-vascular endothelial growth factor, photodynamic therapy, focal laser, or vitrectomy. The demographic and multimodal imaging data were reviewed. The location, angiography features, height and width, presence of retinal pigment epithelium (RPE) aggregations, RPE thickness, and choroid status of the FIPED area were compared between the groups.Results: The mean age of the included chronic CSC patients was 54.3 ± 7.8 years (range: 33–72 years), and 85.1% were male. Vascularized FIPED eyes had a larger width (1,556.4 ± 731.6 vs. 931.1 ± 486.2 μm, p &lt; 0.001), larger subfoveal RPE thickness (33.4 ± 15.3 vs. 26.3 ± 6.6 μm, p = 0.004), larger maximum RPE thickness of the FIPED area (46.3 ± 20.5 vs. 31.5 ± 8.3 μm, p &lt; 0.001), and more RPE aggregations in the FIPED area (94.5 vs. 54.5%, p &lt; 0.001) than avascular FIPED eyes. RPE aggregations in the FIPED area were an independent factor strongly associated with vascularized FIPED (OR = 7.922, 95% CI = 1.346–46.623, p = 0.022).Conclusion: FIPED with a larger width and RPE thickening may suggest the presence of an underlying type 1 CNV. FIPED with RPE aggregations had an increased occurrence of neovascularization in chronic CSC.

scholarly journals Functional and morphological retinal impairment following resolved chronic central serous chorioretinopathy

2018 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Morphological Parameters ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose Central serous chorioretinopathy is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods Thirty-two eyes with chronic central serous chorioretinopathy in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choroidal perfusion even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. No significant correlation between duration of central serous chorioretinopathy and amount of visual deficit has been found, therefore it is possible that the biggest damage occurs within the first months of active chorioretinopathy. Keywords: chronic central serous chorioretinopathy, micropulse laser, central retinal thickness, subretinal fluid

scholarly journals The efficacy of intravitreal conbercept for chronic central serous chorioretinopathy: a retrospective clinical study

2019 ◽  
Author(s):  
Jianbo Mao ◽  
Caiyun Zhang ◽  
Chenyi Liu ◽  
Lijun Shen ◽  
Jimeng Lao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Central Serous Chorioretinopathy ◽  
Central Macular Thickness ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
Retrospective Clinical Study ◽  
The Difference ◽  
Best Corrected Visual Acuity

Abstract Background: To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods: A retrospective clinical study. This study included twenty-seven patients (32 eyes) who were diagnosed with chronic CSC in our hospital from November 2015 to March 2018. All the patients received intravitreal conbercept with one intravitreal injection and pro re nata (PRN). Follow-up observations occurred at 1 week and 1, 2, 3, and 6 months after initial injection. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and presence of subretinal fluid (SRF). Results: During the 6-month follow-up, the mean number of injections required and performed was 1.50±0.67. The BCVA at the first visit, 1-week, 1-, 2-, 3- and 6-month follow-ups after the first injection was 0.44±0.26, 0.39±0.29, 0.38±0.29, 0.33±0.29, 0.31±0.30, and 0.31±0.29, respectively. The difference between the BCVA at each follow-up and the first visit was statistically significant (F=9.717, P<0.05). CMT at the first visit, 1-week, 1-, 2-, 3- and 6- month after first injection was 323.25±158.49μm, 263.78±122.52μm, 222.34±92.46μm, 195.63±69.18μm, 189.25±68.71μm, and 200.47±86.30μm, respectively. The difference between the CMT at each follow-up and the first visit was also statistically significant (F=17.072, P<0.05). Full resolution of fluid was achieved in 7 (21.9%) eyes at 1 month, 14 (43.8%) eyes at 2 months, 19 (59.4%) eyes at 3 months and 23 (71.9%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusion: Intravitreal injection of conbercept can effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months. Keywords: Chronic central serous chorioretinopathy, Conbercept, Best-corrected visual acuity, Central macular thickness.

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